Regional Systems to Treat Severe Heart Attack Increasing

WEDNESDAY, May 23 (HealthDay News) — The number of regional care
systems able to quickly identify, transfer if necessary, and treat
patients experiencing the most severe form of heart attack is increasing,
new research finds.

ST-segment elevation myocardial infarction, or STEMI, is a deadly form
of heart attack that affects nearly 300,000 people in the United States
per year. It occurs when a blood clot completely blocks an artery to the
heart. Quickly restoring blood flow is needed in order to prevent
death.

In a regional STEMI-care system, emergency medical services have the
equipment on their ambulances to diagnose the heart attack on the way to
the hospital, and hospitals cooperate to make sure that patients are
delivered to a facility that can quickly activate a team able to treat the
heart attack. That treatment is often the artery-opening procedure called
percutaneous coronary intervention, commonly known as angioplasty.

Between April 2008 and January 2010, the American Heart Association
conducted a survey of 381 regional STEMI-care systems that included nearly
900 hospitals in 47 states. Each system included at least one hospital
that performs angioplasty, and one emergency medical service provider.

The survey found that 67 percent of the systems were in urban areas and
most followed standard procedures and policies, such as:

  • Admitting STEMI patients even when a hospital bed was not readily
    available (97 percent).
  • Requiring a single phone call to activate the catheterization lab for
    angioplasty (92 percent).
  • Permitting emergency department doctors to activate the
    catheterization lab without consulting a cardiologist (87 percent) and
    allowing the lab to be activated without a cardiology consultation before
    the patient arrives at the hospital (78 percent).
  • Being part of a data collection registry (84 percent).

Competition among hospitals and cardiology groups was the most common
barrier to implementing STEMI care systems. The researchers also found
that about one-quarter of the systems have difficulties with emergency
medical services’ transport and finances.

The study appears in the journal Circulation: Cardiovascular Quality
and Outcomes
.

“It’s essential to get competing hospitals and separate [emergency
medical service] agencies within a community to work as a team to provide
optimal care for heart attack patients,” lead author Dr. James Jollis, a
professor of medicine at Duke University Medical Center, said in a news
release from the American Heart Association.

More information

The U.S. National Heart, Lung, and Blood Institute has more about angioplasty.

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