Effect of Prehospital Cardiac Catheterization Lab Activation on Door-to-Balloon Time, Mortality, and False-Positive Activation

Abstract Background. Reperfusion of ST elevation myocardial infarction (STEMI) is most effective when performed early. Notification of the cardiac catheterization laboratory (cath lab) prior to hospital arrival based on paramedic-performed ECGs has been proposed as a strategy to decrease time to rep...

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Bibliographic Details
Published in:Prehospital emergency care 2014-01, Vol.18 (1), p.1-8
Main Authors: Squire, Benjamin T., Tamayo-Sarver, Joshua H., Rashi, Paula, Koenig, William, Niemann, James T.
Format: Article
Language:English
Subjects:
Angioplasty, Balloon, Coronary
Cardiac Catheterization
catheterization
Electrocardiography
emergency medical services
Emergency Medical Services - organization & administration
Emergency Service, Hospital - organization & administration
False Positive Reactions
Humans
Los Angeles - epidemiology
myocardial infarction
Myocardial Infarction - diagnosis
Myocardial Infarction - mortality
Myocardial Infarction - therapy
Retrospective Studies
Time Factors
Treatment Outcome
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Summary:Abstract Background. Reperfusion of ST elevation myocardial infarction (STEMI) is most effective when performed early. Notification of the cardiac catheterization laboratory (cath lab) prior to hospital arrival based on paramedic-performed ECGs has been proposed as a strategy to decrease time to reperfusion and mortality. The purpose of this study was to compare the effects of cath lab activation prior to patient arrival versus activation after arrival at the emergency department (ED). Methods. We performed a retrospective cohort study (n = 1933 cases) using Los Angeles County STEMI database from May 1, 2008 through August 31, 2009. The database includes patients arriving at a STEMI Receiving Center (SRC) by ambulance who were diagnosed with STEMI either before or after hospital arrival. We compared the cohort of patients with prehospital cath lab activation to those activated from the ED within 5 minutes of first ED ECG. Outcomes measured were mortality, door-to-balloon time, percent door-to-balloon time
ISSN:1090-3127
1545-0066
DOI:10.3109/10903127.2013.836263