Abstract P16: Impact of TIME Project: Improving the SAMU System of Care for STEMI Patient
Background The Heart Institute (InCor) and Anhembi Morumbi University (UAM) Emergency Medicine Intensive Training (TIME) course provides training in the prevention, action and management of STEMI. This course was introduced at our EMS system and we subsequently undertook an analysis to determine its impact on the incidence and outcome of out of hospital STEMI.
Methods A 2-year prospective audit of 3289 out of hospital emergency calls following the organisation-wide adoption of the TIME course. Key measures used to detect improvement were the incidence of emergency calls, in particular the proportion of calls; time to first 12 lead EKG; thrombolyse and survival to hospital discharge; the proportion of clinical staff who were TIME trained was an important organisational measure.
Results We observed a reduction in the time for the first 12 lead EKG (p<0.0001; from 81% to 35%), a corresponding increase in the proportion of thrombolysis (p<0.0001; from 14% to 53%), a reduction in deaths (p=0.0002) and an increased survival to hospital discharge from 26% to 36%. There was a temporal relationship between the proportion of staff who were TIME trained and outcome.
Conclusion The introduction of a simple and widespread educational programme was associated with a reduction in time to first 12 lead EKG, and increase successful in STEMI attempts