Accelerated management of patients with ST-segment elevation myocardial infarction in the ED
Christof Havel1, Wolfgang Schreiber, Günter Christ
1Department of Emergency Medicine, Medical University of Vienna, Austria.
Purposes:
The objective of this study was to evaluate improvement opportunities in the emergency department for timely ST-segment elevation myocardial infarction management and evaluated the new process flow.
Basic Procedures:
In a prospective study, we compared time from door to cath laboratory before and after implementation of a new ST-segment elevation myocardial infarction (STEMI) protocol. The new protocol included a blend of strategies to reduce door to cath laboratory time.
Main Findings:
We included 55 patients. After implementing a new STEMI protocol, we included 54 patients. Time to cath laboratory was 21 (interquartile range, 9-40) minutes before and 10 (interquartile range 5-25) minutes after initiation of the new protocol (P = .02). A door to cath laboratory time less than 15 minutes was reached in 36% of our patients in phase 1 and in 61% in phase 2 (odds ratio; 0.36, 95% confidence interval, 0.16-0.81; P = .01).
Principal Conclusion:
Simple changes in organizational strategies resulted in a significantly faster care for patients with acute uncomplicated STEMI.
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