Better Outcomes with Coordinated Heart Care

EMS helped to speed heart patient transfers

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) Most of us assume if we needed a transfer to a larger hospital for heart attack treatment that it would happen quickly and efficiently. At times the transfers to open blocked arteries happen rapidly.

A study reveals that at other times lack of coordinated care between hospital systems may slow such transfers and subsequent treatment.

The research, published in Circulation: Cardiovascular Quality and Outcomes, an American Heart Association journal, shows that coordinating care between emergency medical personnel and a range of hospital facilities ensures that heart attack patients receive emergency coronary angioplasty in significantly less time.

"Seek emergency treatment at a larger facility if possible."

Study researchers looked at the door to door times of 436 heart attack patients at hospitals in North Carolina and how long it took to transfer patients from smaller hospitals to larger facilities for treatments such as angioplasty. The patients studied were experiencing ST-elevation myocardial infarction (STEMI) ― the most fatal form of heart attack, which occurs when the blood supply is blocked to a large area of the heart.

Patients with this type of heart attack generally need coronary angioplasty or percutaneous coronary intervention to open blocked coronary arteries. Their outcomes are greatly improved if they receive such treatment within 90 minutes of initial medical treatment.

The average time at the beginning of the study was 97 minutes, but one year after a coordinated program was introduced and transfer times improved,  the time dropped to 58 minutes.

The study showed that care protocols implemented by EMS had the largest impact ― a median time improvement from 138 minutes before to 44 minutes after the program began.

Dr. Seth Glickman, M.D., M.B.A., the study’s lead researcher and assistant professor of emergency medicine at the University of North Carolina in Chapel Hill, said that the coordination saves lives. He said expanded integrated systems across the country could further cut patients' time to treatment.

Each year almost 250,000 patients suffer a STEMI in the United States, but only 25 percent of the country’s hospitals are percutaneous coronary intervention capable. During that surgical procedure, a balloon-tipped tube is threaded through an artery to the heart. The balloon is then inflated to widen the artery and restore blood flow.

Reviewed by: 
Review Date: 
June 25, 2011
Last Updated:
June 28, 2011