• Ir J Med Sci · Oct 2024

    Time to ECG diagnosis delays inter-hospital transfer to revascularization in STEMI patients presenting to a regional emergency department: a five-year audit.

    • Jonathan Shpigelman, Anastasia Proshkina, Marin Roman, Ken Maleady, Ivan Casserly, Gavin Blake, Patrick O'Boyle, Lavanya Saiva, Edward Keelan, James O'Neill, and Michael Daly.
    • School of Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland.
    • Ir J Med Sci. 2024 Oct 1; 193 (5): 220322072203-2207.

    BackgroundReducing the door-to-balloon time (D2BT) in ST-elevation myocardial infarction (STEMI) patients maximizes myocardial salvage and mitigates morbidity/mortality.AimsTo assess the D2BT in STEMI patients requiring inter-hospital transfer for revascularization and identify any potential causes of delay.MethodsConsecutive patients presenting to the Connolly Hospital Blanchardstown (CHB) emergency department (ED) who were transferred to the Mater Misericordiae University Hospital in Dublin for primary percutaneous coronary intervention from January 2018 to October 2022 were identified in a regional database and their D2BTs calculated. D2BTs were further sub-categorized into key intervals to identify any potential causes of delay.ResultsA total of 90 patients were included for analysis, with a median D2BT of 117.5 min (interquartile range [IQR]: 99.3-170.8 min) and 52.5% of patients achieving the ≤ 120 min target. Despite being the shortest interval considered, the time from arrival at the CHB ED to diagnostic electrocardiogram (ECG) was a substantial contributor to the overall delay to revascularization given its wide variability (median: 18.0 min; IQR: 9.0-46.8 min), with only 28.8% of patients achieving the ≤ 10 min target.ConclusionsNearly half of the patients studied failed to achieve the overall target D2BT for revascularization. The time from arrival at the CHB ED to diagnostic ECG was identified as a substantial contributor to this failure, with a median time almost twice that of the target and a quarter of all patients spending longer than 46.8 min. These findings highlight a need to improve the implementation of ECG triage and interpretation in the ED.© 2024. The Author(s).

      Pubmed     Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…