Coordination of Emergency Care Ups STEMI Survival Rates
(HealthDay News) — Improved coordination between paramedics and hospitals can reduce ST-segment elevation myocardial infarction (STEMI) deaths nearly five-fold by getting patients quicker treatment, according to research of an initiative to be presented Wednesday at the annual meeting of the American Heart Association, held from November 15–19 in Chicago.
The initiative, called Mission: Lifeline and coordinated through Duke University, was conducted with 484 hospitals and 1,258 emergency medical service agencies in 16 cities. Researchers found it resulted in slight reductions in the time it took to get patients from their first contact with a medical professional into an operating room. But those small reductions had enormous benefits: death rates were dramatically reduced by getting people into surgery even 15 minutes sooner than normal.
As part of the program, researchers helped local agencies craft their own plans for coordinating heart attack care among paramedics, hospital staff, and cardiologists, study coauthor James Jollis, MD, chairman of Mission: Lifeline, told HealthDay. The goal was to reduce to <90 minutes the amount of time between when a paramedic or emergency department worker sees a STEMI patient and when the patient receives reperfusion therapy.
Only 2.3% of patients who waited <30 minutes in an emergency department for treatment died, compared to 7.7% of people who waited for 30–45 minutes and 11.2% of those who had to wait >45 minutes, the researchers found. The results also showed that people who call paramedics during a STEMI receive quicker medical attention. Patients who dialed 911 had their first medical contact 47 minutes after the onset of symptoms, while those who drove themselves to the hospital took 114 minutes to see a health care professional.