PMID- 20186239
OWN - NLM
STAT- MEDLINE
DCOM- 20100406
LR  - 20101118
IS  - 1175-8716 (Electronic)
IS  - 0028-8446 (Linking)
VI  - 123
IP  - 1309
DP  - 2010 Feb 19
TI  - Door to balloon times: streamlining admission for primary percutaneous coronary 
      intervention.
PG  - 18-25
AB  - AIMS: Primary angioplasty is superior to thrombolysis in ST elevation myocardial 
      infarction (STEMI). This advantage is dependent on how quickly angioplasty can be 
      performed. Several strategies have been suggested to cut door to balloon (D2B) 
      times. We aimed to audit and reorganise the admission process to accelerate D2B 
      times, in Waikato Hospital, New Zealand. METHODS: The admission process for STEMI 
      was audited. Three changes were made. One step in the catheterisation lab 
      activation system (referral to cardiology registrar on call) was removed. Single 
      call pager activation of the catheterisation lab team was adopted. Feedback of 
      timing performance data by email and printout was established. Timing data were 
      collected for 6 months before and after these changes. RESULTS: After the 
      admission process was changed 88.5% of patients had a D2B time <90 min vs 63.6% 
      before. Median D2B times were reduced from 74.5 min to 59 min (p=0.09). Median 
      time from admission to arrival at cath lab was reduced from 50 min to 35 min 
      (p=0.019). CONCLUSIONS: Relatively minor changes in admission process, without 
      new resources, can lead to reductions in door to balloon times. This was achieved 
      in a hospital with a selective PPCI policy and modest annual volume of PPCI.
FAU - Swanson, Neil
AU  - Swanson N
AD  - Cardiology Department, James Cook University Hospital, Middlesborough, TS4 3BW, 
      UK. neil.swanson@stees.nhs.uk
FAU - Nunn, Christopher
AU  - Nunn C
FAU - Holmes, Steve
AU  - Holmes S
FAU - Devlin, Gerry
AU  - Devlin G
LA  - eng
PT  - Journal Article
DEP - 20100219
PL  - New Zealand
TA  - N Z Med J
JT  - The New Zealand medical journal
JID - 0401067
SB  - IM
CIN - N Z Med J. 2010 Feb 19;123(1309):7-10. PMID: 20186236
CIN - N Z Med J. 2010 Mar 5;123(1310):122. PMID: 20360789
MH  - *Angioplasty, Balloon, Coronary
MH  - *Clinical Protocols
MH  - Feedback
MH  - Female
MH  - Humans
MH  - Male
MH  - Medical Audit
MH  - Middle Aged
MH  - Myocardial Infarction/*therapy
MH  - New Zealand
MH  - *Patient Admission
MH  - Time Factors
EDAT- 2010/02/27 06:00
MHDA- 2010/04/07 06:00
CRDT- 2010/02/27 06:00
PHST- 2010/02/27 06:00 [entrez]
PHST- 2010/02/27 06:00 [pubmed]
PHST- 2010/04/07 06:00 [medline]
PST - epublish
SO  - N Z Med J. 2010 Feb 19;123(1309):18-25.