PMID- 18340157
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20091211
LR  - 20080314
IS  - 1535-2811 (Electronic)
IS  - 1535-2811 (Linking)
VI  - 3
IP  - 3
DP  - 2004 Sep
TI  - A rapid-response alphanumeric paging design decreases door-to-balloon times in 
      patients undergoing primary percutaneous coronary intervention for ST elevation 
      acute myocardial infarction.
PG  - 150-3
LID - 10.1097/01.hpc.0000139463.57231.9f [doi]
AB  - INTRODUCTION: In acute ST elevation myocardial infarction (STEMI), rapid 
      reperfusion of the infarcted artery improves cardiovascular outcomes; however, 
      many hospitals have difficulty achieving recommended times. We hypothesized that 
      a Rapid-Response Alphanumeric Paging Design (RAPiD) would reduce door-to-balloon 
      time for primary percutaneous coronary intervention (PCI) in STEMI. METHODS: A 
      chest pain algorithm and interdisciplinary team was established in December 2000. 
      In August 2002, RAPiD was instituted to transmit the diagnosis and location of a 
      STEMI to the chest pain team through a speed-dial button. All patients presenting 
      to our emergency department from February 2002 through July 2003 with STEMI were 
      included. Exclusion criteria included lack of chest pain, cardiopulmonary arrest 
      before PCI, and catheterization or PCI not performed. Outside-referral STEMI, 
      in-patient STEMI, and failed thrombolysis patients were excluded. Data was 
      obtained from medical records. Log transform of door-to-balloon (DTB) times was 
      performed. RESULTS: Forty-seven events satisfied inclusion and exclusion criteria 
      with 32 occurring after RAPiD (post-RAPiD). Fifteen events occurred during 
      on-hours (8 am to 7 pm on weekdays). Mean untransformed DTB times pre- and 
      post-RAPiD were 162 +/- 137 (standard deviation) minutes and 112 +/- 41 minutes. 
      The main effects analysis of variance model showed a significant reduction in 
      post-RAPiD DTB time (P = 0.03) with a mean reduction of 26% during off-hours and 
      20% during on-hours. The post-RAPiD estimate of mean DTB time, derived from the 
      antilog of the log transform, was 96.7 minutes (95% confidence interval, 
      83.7-111.7). CONCLUSIONS: The institution of RAPiD in a hospital with a 
      preexisting chest pain algorithm significantly decreases DTB times so as to 
      satisfy current ACC/AHA guidelines.
FAU - Goyal, Neil K
AU  - Goyal NK
AD  - Division of Cardiology, Columbia University Medical Center, New York Presbyterian 
      Hospital and Columbia University College of Physicians and Surgeons, New York, NY 
      10032, USA.
FAU - Giglio, James
AU  - Giglio J
FAU - Lorberbaum, Miriam
AU  - Lorberbaum M
FAU - Hurley, Eileen
AU  - Hurley E
FAU - Stant, Jennifer
AU  - Stant J
FAU - Esposito, Francesca
AU  - Esposito F
FAU - Sciacca, Robert
AU  - Sciacca R
FAU - Apfelbaum, Mark
AU  - Apfelbaum M
FAU - Rabbani, LeRoy E
AU  - Rabbani LE
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Crit Pathw Cardiol
JT  - Critical pathways in cardiology
JID - 101165286
EDAT- 2008/03/15 09:00
MHDA- 2008/03/15 09:01
CRDT- 2008/03/15 09:00
PHST- 2008/03/15 09:00 [pubmed]
PHST- 2008/03/15 09:01 [medline]
PHST- 2008/03/15 09:00 [entrez]
AID - 10.1097/01.hpc.0000139463.57231.9f [doi]
PST - ppublish
SO  - Crit Pathw Cardiol. 2004 Sep;3(3):150-3. doi: 10.1097/01.hpc.0000139463.57231.9f.