Most Hospitals Not Able to Meet 90-Minute Deadline for Performing Balloon Inflation for Acute Myocardial Infarction

By Michael Zerres

Study Shows Minority of Hospitals Surveyed Have A System That Ensures Compliance with Current Guidelines

The American College of Cardiology and American Heart Association have established guidelines for the treatment of an acute heart attack. They require, in part, percutaneous coronary intervention to increase perfusion within 90 minutes or less from when a patient presents to the hospital with an acute myocardial infarction. Such therapy significantly increases the chances of patient survival. However, few hospitals have been able to meet these guidelines. A recent study published 11-14-06 in the New England Journal of Medicine determined that those hospitals that comply with established guidelines (a minority of 365 hospitals surveyed) have set in place specific strategies that assure the patient is reperfused in a timely manner. The successful strategies that reduced “Door to Balloon” time include: having ER physicians ‘activate’ the cardiac catheterization lab, having a single call to a central page operator activate the cath lab, having the ER Dept. activate the cath lab while the patient is en route to the hospital, expecting staff to arrive in the cath lab within 20 minutes after being paged, and, having an attending cardiologist always in site. Arguably, hospitals that do not implement proper strategies to attempt to comply with ACC/AHA guidelines do not meet the standard of care.

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