Emergency Department, Geneva University Hospitals, Geneva, Switzerland.
Swiss Med Wkly. 2010 Apr 17;140(15-16):228-32. doi: 10.4414/smw.2010.12927.
To explore whether early activation of an interventional cardiology team, by prehospital emergency physicians, reduces door-to-balloon time (DTBT) in patients with ST-elevation myocardial infarction (STEMI) diagnosed with prehospital ECG.
before-after comparison.
emergency department (ED) of an urban teaching hospital with a catheterisation laboratory open continuously.
patients with STEMI diagnosed in the prehospital setting or in the ED within 12 hours of symptoms.
a paging system or "STEMI alarm", activated by prehospital physicians, which simultaneously notified both the catherisation laboratory and cardiology teams before the patient's arrival to the ED.
DTBT and the proportion of patients with DTBT <90 minutes.
A total of 196 patients were included; 77 before and 119 after implementation of the "STEMI alarm". Between the two periods, median DTBT decreased from 109 to 76 minutes (p <0.001) and the proportion of patients treated within 90 minutes increased from 36% to 66% (p <0.001). During intervention, the STEMI alarm was activated in 67 patients (56%). In these cases the median DTBT was 50 minutes, with 96% within 90 minutes. The alarm was inappropriately activated in 9 cases (11%).
Catheterisation laboratory activation by a prehospital emergency physician markedly reduces DTBT in STEMI patients.
探讨通过院前急救医生提前激活介入心脏病学团队是否能降低院前心电图诊断为 ST 段抬高型心肌梗死（STEMI）患者的门球时间（DTBT）。
前后比较。
设有导管实验室的城市教学医院急诊部，该实验室持续开放。
在院前或症状出现 12 小时内于 ED 诊断为 STEMI 的患者。
院前医生激活的传呼系统或“STEMI 警报”，在患者到达 ED 之前同时通知导管实验室和心脏病学团队。
DTBT 和 DTBT<90 分钟的患者比例。
共纳入 196 例患者；实施“STEMI 警报”前 77 例，后 119 例。在这两个时期之间，中位 DTBT 从 109 分钟降至 76 分钟（p<0.001），90 分钟内接受治疗的患者比例从 36%增至 66%（p<0.001）。在干预期间，67 例患者（56%）激活了 STEMI 警报。在这些情况下，中位 DTBT 为 50 分钟，96%在 90 分钟内。有 9 例（11%）警报被不恰当地激活。
院前急救医生提前激活导管实验室可显著缩短 STEMI 患者的 DTBT。
