Hospitals are speeding up heart attack care

Many of us have seen the chaos in an emergency room, whether on TV or in real life. Overcrowding, too many patients, too few staff who are mostly overworked and lacking sleep. It is more than likely that patients do not immediately get the care that they need. In many cases, however, treatments are time critical and should be delivered within a time window or else it is too late.

This is why many hospitals are speeding up heart attack care. This good news is reported in the Journal of the American College of Cardiology. Receiving care in the shortest possible time, such as opening blocked arteries in the emergency room, is crucial to heart attack patients’ survival. When the arteries are blocked, blood supply to the heart muscle is cut off. The sooner the blood flow is restore, the better chances for heart recovery. Long periods of blood and oxy gen depletion can cause long-lasting and irreversible damage to the heart. Thus, hospitals and cardiologists worked to improve “door to balloon time”, with positive results.

“Door to balloon time” refers to the time when the patient arrives at the hospital until he or she gets an angioplasty or nay standard clinical procedure that clears the blocked coronary arteries.

Here’s how angioplasty works (Medline Plus):

“The doctor threads a thin tube through a blood vessel in the arm or groin up to the involved site in the artery. The tube has a tiny balloon on the end. When the tube is in place, the doctor inflates the balloon to push the plaque outward against the wall of the artery. This widens the artery and restores blood flow.”

The shorter the door to balloon time, the better are the chances for survival and full recovery.

Researchers at Yale University looked at 831 hospitals all the US to evaluate whether the ongoing campaign to accelerate care for heart attack patients is working. In 2005, only about 50% of patients get the necessary treatment within 90 minutes of arrival at the emergency room. The current figures estimated by the Yale survey were very encouraging.

Spring 2008: More than three-quarters (76%) of people suffering major heart attacks are getting their blocked arteries reopened within 90 minutes of arriving in the emergency room.

Summer 2009: Nearly 82% of eligible patients had a 90-minute or less door-to-balloon time in those hospitals.

These improvement in providing care however, were only observable in those hospitals participating in the care acceleration campaign. Some “slower” hospitals are now getting the message and are following suit.

So how did the hospitals manage to accelerate heart attack care?

The changes that helped most were simple steps that cut a few minutes here and few there. One such step was letting the emergency room activate the catheter lab upon the patient’s arrival, or even after a call from the ambulance on its way, instead of waiting for a cardiologist to confirm the diagnosis before getting ready for angioplasty. Some hospitals assigned cardiac catheter teams to be on duty 24 hours a day. Others required that on-call doctors arrive within minutes of a page from the ER.

Photo credit: Medline Plus