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Posted 2006-11-29 08:58:14

In an acute heart attack (with ST segment elevation), the recommended goal is the interval between arrival at the hospital and intracoronary balloon inflation (door-to-balloon time) during should be 90 minutes or less. However, few hospitals meet this objective. A study in the New England Journal of Medicine identified six factors that were significantly associated with a faster door-to-balloon time. These strategies included having emergency medicine physicians activate the catheterization laboratory (mean reduction in door-to-balloon time, 8.2 minutes), having a single call to a central page operator activate the laboratory (13.8 minutes), having the emergency department activate the catheterization laboratory while the patient is en route to the hospital (15.4 minutes), expecting staff to arrive in the catheterization laboratory within 20 minutes after being paged (vs. >30 minutes) (19.3 minutes), having an attending cardiologist always on site (14.6 minutes), and having staff in the emergency department and the catheterization laboratory use real-time data feedback (8.6 minutes).

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