Camden Clark Medical Center has implemented several measures to significantly decrease average door-to-balloon time, exceeding national guidelines, and improving care of patients with the most severe type of heart attack, known as STEMI (ST-segment-elevation myocardial infarction).
Door-to-balloon time is the interval from a STEMI patient arrival at the emergency room to the performance of balloon angioplasty by an interventional cardiologist a lifesaving procedure during which a balloon-tipped catheter is threaded into the blocked artery, and then inflated to compress the clot allowing restoration of blood flow to the heart.
Guidelines developed over the past decade call for hospitals to meet a 90-minute or less time standard for treatment with angioplasty, starting from the moment a patient enters the hospital until the balloon is inflated and blood flow is restored. Camden Clark's average time is currently just over 60 minutes.
According to Dr. John Goddard, interventional cardiologist, Camden Clark Medical Center has worked to advance the quality of care for heart attack patients in several ways. One of those is the purchase of the LIFENET System. It has significantly increased communication and coordination of care between EMS, the Emergency Department, Interventional Cardiology, and the Cardiac Catheterization Laboratory.
This system allows the Emergency Department Physician to interpret the EKG prior to arrival and activate the on-call team for patients with acute myocardial infarction before the patient reaches the ED. This process allows the Interventional Cardiologist and Cardiac Catheterization Laboratory staff to begin preparation for the patient prior to the patient arriving at the facility, which in turn reduces the amount of time required to restore blood flow to the myocardium, thus saving cardiac muscle and function.
There is evidence to show that reducing "door-to-balloon" time lowers a patient's risk of death and serious damage to the heart muscle. Studies indicate that 85% of heart damage occurs within the first two hours of a heart attack.
"We have also developed a multidisciplinary team, which consists of representation from EMS, the Emergency Department, Interventional Cardiology, the Cardiac Catheterization Lab Staff, Hospital Nursing, and the Quality Department to continually evaluate the standards of care and performance," said Dr. Goddard. "This team has also developed criteria empowering EMS to activate the cath lab for acute myocardial infarction when transmission of the pre-hospital EKG is not possible."