Relationship between door-to-balloon time and clinical experience level of emergency department physicians

This study aimed to investigate the relationship between the experience level of physicians initially making the clinical diagnosis of ST-segment elevation myocardial infarction in the emergency department and door-to-balloon time (DBT).

The study group comprised 522 patients with ST-elevation myocardial infarction who were immediately treated in the catheter laboratory. Information about DBT, the experience level of the physicians who initially clinically diagnosed the patients and clinical benefit parameters were collected. The experience level of the physicians was divided into three groups: medical practitioner (no emergency training; n = 351), assistant physician (undergoing emergency medicine training; n = 111) and emergency medicine specialist (n = 60). DBT was compared among these groups.

The average DBT was 80.3 ± 83.2 minutes for medical practitioners, 77.5 ± 74.7 minutes for assistant physicians and 53.6 ± 28.1 minutes for emergency medicine specialists. The difference in DBT between the emergency medicine specialist group and others was statistically significant (P = .046).

DBT decreased as the experience level of the emergency physician increased, but randomisation is required to determine the clinical benefit of this effect.