Study Confirms That New Protocol Shortens The Time It Takes To Open Blocked Arteries For Heart Attack Patients

Main Category: Cardiovascular / Cardiology
Also Included In: Conferences;  Public Health
Article Date: 10 Nov 2007 - 0:00 PDT

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This week, Dr. Fouad Bachour, MD, FACC, director of interventional cardiology at Hennepin County Medical Center, presented results of a study at the American Heart Association's Scientific Sessions meeting in Orlando showing that alerting the hospital as soon as possible before a heart attack patient arrives improves door-to-balloon times -- both during workday hours and after hours. Door-to-balloon time is measured from the time the patient arrives in the emergency department to when the patient's artery is opened and blood flow to the heart is restored in the cardiac catheterization lab.

National studies have shown that during normal workday hours, when cardiac catheterization (cath) labs are fully staffed, the time it takes to open a patient's blocked artery is shorter than after hours when staff has to be called in. Hennepin County Medical Center has reduced the time it takes to get a patient with an acute heart attack to the cath lab for emergency angioplasty by authorizing paramedics to call ahead and alert the cath lab staff directly instead of receiving prior authorization. There's no dispute within the medical community that the quicker the patient receives treatment, the better chance for survival.

"Without blood, cardiac muscle quickly begins to die," explains Dr. Bachour. "The largest gain in time to an open artery can be achieved by concentrating our efforts on management of the pre-hospital phase of patients coming in with a heart attack. Hennepin has been very successful at restoring blood flow to heart tissue and saving lives." Every year an estimated 500,000 Americans experience heart attacks which occur when an artery is completely blocked and blood flow to cardiac muscle is restricted.

According to Dr. Bachour, empowering paramedics to activate the cath lab as soon as they assess the patient at the scene means the cath lab staff are ready and waiting for the patient as soon as he/she arrives at the hospital. Door-to-balloon times using this protocol can be much quicker than the national standard of 90 minutes -- no matter what time of the day.

In 2005, Hennepin paramedics began activating the cardiac cath lab from the field and rigs when they began carrying an electrocardiogram, or EKG, which is used to measure the heart's electrical activity to identify heart attack patients. Since this protocol has been in place, the following door-to-balloon times have been reported:

-- Average door-to-balloon time during regular workday hours decreased from 73 to 49 minutes

-- Average door-to-balloon time AFTER regular business hours decreased from 94 to 65 minutes

"We worked very closely with our paramedics and they are directly responsible for the program's success. Using the information we've learned, we hope that more hospitals will see what a difference pre-hospital cath lab activation can make, and that they might consider making similar changes in the way they care for heart attack patients."

Hennepin County Medical Center is a nationally recognized Level 1 Trauma Center with the largest emergency department in Minnesota. The comprehensive academic medical center and public teaching hospital includes a 424-bed acute care hospital and clinics located in downtown Minneapolis and suburban Hennepin County. For the eleventh year in a row, Hennepin is listed in the U.S. News & World Report rankings of the top U.S. Hospitals in its annual "America's Best Hospitals" report. http://www.hcmc.org

Hennepin County Medical Center
http://www.hcmc.org

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