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Cardiac cath lab activation by the emergency physician without prior consultation decreases door-to-balloon time.
J Invasive Cardiol. 2005 Mar; 17(3):154-5.JI

Abstract

OBJECTIVE

The purpose of this before-and-after study is to determine whether an ED strategy which calls for cardiac catheterization lab (cath lab) activation directly by the emergency physician (EP) is effective in decreasing door-to-balloon time (DTBT).

METHODS

In our active community teaching hospital ED, with an annual census of 55,000, the traditional practice for STEMI required cardiology consultation prior to cath lab notification. In November 2003 we instituted an ED protocol which mandated direct cath lab activation by the EP for eligible STEMI patients without prior notification of the cardiologist. We measured clinically relevant time intervals, including DTBT, prior to and after institution of the protocol.

RESULTS

Twenty-four patients were enrolled after institution of the protocol; these were compared to twenty STEMI patients enrolled prior to the new protocol. DTBT decreased significantly, from 118 to 89 minutes, p=.039. Other ED parameters, including door to exam (17 vs. 15 minutes) and total ED time (80 vs. 56 minutes, p = .056) decreased post-protocol but were not significantly different for the two periods. Those arriving by ambulance continued to have a significantly lower DTBT than non-ambulance patients (pre: change of 47 minutes, p = .03, post: change of 33 minutes; p = .012). Both groups were affected similarly by the change in protocol, decreasing DTBT by approximately 25%.

CONCLUSION

We conclude that a strategy which mandates cath lab activation by the emergency physician for STEMI without prior cardiology consultation, reduces door to balloon time.

Authors+Show Affiliations

St. Luke's Hospital, Emergency Medicine Residency, 801 Ostrum Street, Bethlehem, PA, 18015, USA. jeannejacoby38@yahoo.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

15867444

Citation

Jacoby, Jeanne, et al. "Cardiac Cath Lab Activation By the Emergency Physician Without Prior Consultation Decreases Door-to-balloon Time." The Journal of Invasive Cardiology, vol. 17, no. 3, 2005, pp. 154-5.
Jacoby J, Axelband J, Patterson J, et al. Cardiac cath lab activation by the emergency physician without prior consultation decreases door-to-balloon time. J Invasive Cardiol. 2005;17(3):154-5.
Jacoby, J., Axelband, J., Patterson, J., Belletti, D., & Heller, M. (2005). Cardiac cath lab activation by the emergency physician without prior consultation decreases door-to-balloon time. The Journal of Invasive Cardiology, 17(3), 154-5.
Jacoby J, et al. Cardiac Cath Lab Activation By the Emergency Physician Without Prior Consultation Decreases Door-to-balloon Time. J Invasive Cardiol. 2005;17(3):154-5. PubMed PMID: 15867444.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cardiac cath lab activation by the emergency physician without prior consultation decreases door-to-balloon time. AU - Jacoby,Jeanne, AU - Axelband,Jennifer, AU - Patterson,John, AU - Belletti,Daniel, AU - Heller,Michael, PY - 2005/5/4/pubmed PY - 2005/5/20/medline PY - 2005/5/4/entrez SP - 154 EP - 5 JF - The Journal of invasive cardiology JO - J Invasive Cardiol VL - 17 IS - 3 N2 - OBJECTIVE: The purpose of this before-and-after study is to determine whether an ED strategy which calls for cardiac catheterization lab (cath lab) activation directly by the emergency physician (EP) is effective in decreasing door-to-balloon time (DTBT). METHODS: In our active community teaching hospital ED, with an annual census of 55,000, the traditional practice for STEMI required cardiology consultation prior to cath lab notification. In November 2003 we instituted an ED protocol which mandated direct cath lab activation by the EP for eligible STEMI patients without prior notification of the cardiologist. We measured clinically relevant time intervals, including DTBT, prior to and after institution of the protocol. RESULTS: Twenty-four patients were enrolled after institution of the protocol; these were compared to twenty STEMI patients enrolled prior to the new protocol. DTBT decreased significantly, from 118 to 89 minutes, p=.039. Other ED parameters, including door to exam (17 vs. 15 minutes) and total ED time (80 vs. 56 minutes, p = .056) decreased post-protocol but were not significantly different for the two periods. Those arriving by ambulance continued to have a significantly lower DTBT than non-ambulance patients (pre: change of 47 minutes, p = .03, post: change of 33 minutes; p = .012). Both groups were affected similarly by the change in protocol, decreasing DTBT by approximately 25%. CONCLUSION: We conclude that a strategy which mandates cath lab activation by the emergency physician for STEMI without prior cardiology consultation, reduces door to balloon time. SN - 1042-3931 UR - https://www.unboundmedicine.com/medline/citation/15867444/Cardiac_cath_lab_activation_by_the_emergency_physician_without_prior_consultation_decreases_door_to_balloon_time_ L2 - https://medlineplus.gov/heartattack.html DB - PRIME DP - Unbound Medicine ER -