Achieving high quality in ST-segment elevation myocardial infarction care: one urban academic medical center experience

Critical Pathways in Cardiology
Yanina A Purim-Shem-TovDino P Rumoro

Abstract

Management of acute myocardial infarction with ST elevation (STEMI) remains a challenge for academic institutions. There are numerous factors at play from the time electrocardiogram is obtained to the time the patient arrives to a catheterization laboratory and the balloon is inflated. Academic hospitals that are located in large urban centers have to deal with staff living long distances from the facility, and therefore, assembling the catheterization team after-hours and on the weekends becomes a difficult task to achieve. There are other factors that contribute to time delays, such as, administering electrocardiograms in timely fashion, having emergency physicians activate the catheterization team, instead of contacting the cardiologist to discuss the case, and other time-sensitive factors. All of the aforementioned issues contribute to the delay. Yet, primary percutaneous coronary intervention is clearly demonstrated as the modality of choice in treatment of STEMI, which improves patient's morbidity and mortality. Therefore, it is imperative that institutions do all they can to improve their protocols and meet the core measures in the treatment of STEMI patients, including the door-to-balloon time of less than 90 minutes. O...Continue Reading

References

Oct 18, 2008·Journal of the American College of Cardiology·Elliott M Antman
May 26, 2009·JACC. Cardiovascular Interventions·Christopher B Granger
Jul 8, 2009·Heart·Martin Rothman, Rodney De Palma
Jan 12, 2010·Journal of Cardiovascular Pharmacology and Therapeutics·Gervasio A LamasDavid P Faxon

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