Abstract 14054: ‘Call 911’ from STEMI Referral Facilities to STEMI Receiving Centers Reduced Times to Treatment in Patients Receiving Primary Percutaneous Coronary Intervention in Los Angeles County
Background Primary PCI (PPCI) is the preferred method of reperfusion for STEMI, but only if performed in a timely manner (D2B ≤ 90 minutes) by an experienced interventional cardiologist at a high volume STEMI Receiving Center (SRC). However, an estimated 50% of STEMI patients present to STEMI Referral Facilities (SRF) without PPCI capability. Transfer of STEMI patients for PPCI is associated with markedly prolonged transfer times and has not been used extensively in the United States. It is unclear if a regionally integrated transfer system can safely improve transfer times to meet current guidelines.
Methods Simple, standardized protocols were developed in several hospitals in 2008, and more recently, a “Call 911” program was developed and regionalized within Los Angeles County, enabling paramedics to directly transfer STEMI patients from an SRF to a STEMI Receiving Center. Time to treatment goals were suggested to be ≤ 120 minutes.
Results Patient outcomes were unaffected by the increased transfer times. (p=NS).
Conclusions Times to treatment were increased but were <120 minutes and trended downward over 3 years but remained above guideline recommendations in this intergrated system. To encourage participation of hospitals and improve time to treatment goals, efforts to decrease overall times to treatment (≤ 120 minutes), and not a focus on a fixed goal of ≤ 90 minutes, increased the number of safely transferred patients.
- © 2011 by American Heart Association, Inc.