MedicineWorld.Org
Your gateway to the world of medicine
Home
News
Cancer News
About Us
Cancer
Health Professionals
Patients and public
Contact Us
Disclaimer

Medicineworld.org: Better, faster heart attack care

Back to heart watch blog Blogs list Cancer blog  


Subscribe To Heart Watch Blog RSS Feed  RSS content feed What is RSS feed?

Better, faster heart attack care




A North Carolina team of doctors, nurses, hospitals and emergency medical service workers has come up with a way to provide faster, more effective therapy for heart attack patients.

It doesnt require expensive drugs or fancy new equipment. But it does require competitors to become collaborators, and it calls on everyone involved to move therapy forward empowering emergency services personnel in the field to diagnose a heart attack, something only physicians had done before.

Working as partners, rather than as rivals, the team, led by clinicians at Duke University Medical Center, was able to dramatically slash the time from diagnosis to therapy with potentially life-saving therapies, particularly in the area of transfers into and out of smaller, feeder hospitals.



Better, faster heart attack care

Results of the two-year project, called RACE (Reperfusion of Acute Myocardial Infarction in North Carolina Emergency departments), were presented today at the annual meeting of the American Heart Association.

Heart disease is the number one killer in North Carolina, and this program resulted in patients being treated faster and more effectively with life-saving care, said Dr. Christopher Granger, a heart specialist at Duke University Medical Center and a lead investigator of the project. While several other, smaller, city-wide health systems like Boston and Minneapolis have mounted similar efforts, this is the first to demonstrate dramatic system-wide improvement on a statewide scale. We are so encouraged by the results that we feel the RACE system may be a model for change throughout the rest of the country.

There are three times as a number of deaths from heart attacks as there are from car accidents, said Dr. James Jollis, a heart specialist and senior author of the study. But while we have a trauma system to take care of accident victims, we dont have any sort of system to take care of people who suffer heart attacks.

Design of the RACE project was based on a trauma system. It involved caregivers at 65 hospitals and associated emergency medical teams throughout North Carolina. Participants were divided into five regions Greenville, Durham, Winston-Salem, Charlotte and Asheville. Everyone focused on a single goal to provide the fastest, most beneficial care to the greatest number of heart attack patients eligible for reperfusion, or artery-opening treatment. Reperfusion therapies include clot-dissolving drugs and blood thinners as well as a surgical procedure called angioplasty that uses slender catheters carrying balloons and stents to prop open blocked vessels.

Physicians in the RACE program credit the decision to move care forward with much of the programs success. Moving care forward means enabling first responders to do as much of the work as possible. To that end, paramedics were trained to do the work of emergency room physicians and emergency room physicians were trained to do the work of heart specialists. A single phone call from the field was enough to bring an angioplasty team to the catheterization lab, and hospitals had to admit heart attack patients, even if they didnt have any beds. Heart specialists had to give up some of the control we were used to having, says Jollis. It was a hard habit to break. But once we saw the results, we knew we could trust the process.

Over the two years of the program, physicians collected information on 2,000 patients, measuring pre and post-intervention times for key processes: the time from when the patient arrives at the hospital door to either angioplasty or clot-busting treatment, and the time it takes for a patient at a feeder hospital to enter and leave the transferring hospital, and the time a patient enters a feeder hospital to therapy at a second, receiving hospital. Times improved substantially in all areas.
  • Median time from door to therapy for hospitals offering angioplasty fell from 85 to 74 minutes. (22 percent)
  • Median time from door to infusion of clot-busting treatment fell from 35 to 29 minutes. (17 per cent)
  • Median time from door-in to door-out at transfer hospitals fell from 120 to 71 minutes. (41 per cent)
  • Median time from arriving at a feeder hospital to beginning therapy at a receiving hospital fell from 149 minutes to 106 minutes. (29 per cent)

Studies show that heart attack patients treated with reperfusion therapies within 90 minutes do best. But a number of people who are eligible to get these therapys dont get them in time, or dont get them at all, says Jollis. Now, we know how to change that.


Posted by: Daniel    Source




Did you know?
A North Carolina team of doctors, nurses, hospitals and emergency medical service workers has come up with a way to provide faster, more effective therapy for heart attack patients. It doesnt require expensive drugs or fancy new equipment. But it does require competitors to become collaborators, and it calls on everyone involved to move therapy forward empowering emergency services personnel in the field to diagnose a heart attack, something only physicians had done before.

Medicineworld.org: Better, faster heart attack care

Main Page| Cancer blog| Cancer blogs list| Lung cancer blog| Colon cancer blog| Prostate cancer blog| Breast cancer blog| Diabetes watch blog| Heart watch blog| Allergy blog| Bladder cancer blog| Cervical cancer blog| Colon cancer news blog| Diabetes news blog| Esophageal cancer blog| Gastric cancer blog| Health news blog| Heart news blog| Infectious disease blog| Kidney watch blog| Lung disease blog| Lung cancer news blog| Mesothelioma blog| Neurology blog| Breast cancer news blog| OBGYN blog| Ophthalmology blog| Ovarian cancer blog| Cancer news blog| Pancreas cancer blog| Pediatrics blog| Prostate cancer news blog| Psychology blog| Research blog| Rheumatology blog| Society news blog| Uterine cancer blog| Weight watch blog|

Copyright statement
The contents of this web page are protected. Legal action may follow for reproduction of materials without permission.