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March
1, 2010
AMKY and KDMC Meet, Exceed National Standard for Door-to-Balloon Times
“Door-to-balloon”
is a time measurement in emergency cardiac care (ECC), specifically in the
treatment of ST segment elevation myocardial infarction (or STEMI). The
interval starts with the patient's arrival to KDMC rooftop helipad and
ends when a catheter guide wire crosses the culprit lesion in the cardiac
cath lab. When dealing with a myocardial infarction, the adage "time
is muscle" holds true; delays in treatment increase the likelihood
and amount of cardiac muscle damage due to localized hypoxia. ACC/AHA
guidelines recommend a door-to-balloon time period of no more than 90
minutes.
In
the last year Air Methods Kentucky has set record-breaking times in
cardiac scene flights, transporting the patient from rural areas by
picking the patient directly up from local
EMS
agencies. This success must be attributed to outreach education by
King’s Daughters Medical Center (KDMC) and Air Methods Kentucky (AMKY)
to local
EMS
providers as well as the supplying of 12 lead EKG monitors by KDMC. This
has allowed
EMS
to obtain, properly interpret, and transmit the EKG from some areas via
mobile phone directly to the emergency department for early activation of
the cath lab team. In some areas of the state, EMS is unable to transmit
due to cellular phone coverage, so at this point is it reliant upon the
EMS provider and air medical team to interpret and transmit the findings
via radio communications.
Previously,
patients were transported to the emergency department, evaluated by a
physician, and then transported to the cath lab, resulting in an average
door-to-balloon time of 36 minutes. The fastest time of 21 minutes was set
by the KY-10 Grayson base and Elliott County EMS, achieved by the patient
remaining on the AMKY stretcher and then being transported to the cath
lab. The average time of 36 minutes was well below the national standard,
but there was still room for improvement.
The
next step in this process was determining if patients could be transported
directly from the scene to the cath lab (passing the emergency department)
without being in violation of any laws or regulations. The topic was
researched and after a few meetings with the cath lab and emergency
department staff, approval was given to start this practice.
At
the end of 2009, AMKY and KDMC had an average door-to-balloon time of 17
minutes when bypassing the emergency department, with the fastest time
being 15 minutes set by the KY-10 Grayson base and Net Care EMS/Martin
County, Ky.
In
conclusion, it must be emphasized that these greatly improved times are
attributed to the outreach education provided by both KDMC and AMKY,
working jointly to provide world-class care for the communities they
serve. Local
EMS
services should also be commended for their early recognition and
treatment of cardiac emergencies in the field and determining the
appropriate mode of transport and receiving facility.
AMKY
and KDMC continue to work together with a quality assurance program and
review all transports to determine what areas can be improved upon for the
best patient care and service to the communities they serve.
Information courtesy Chad Binion, Flight Medic/Outreach Coordinator,
KY-10/Grayson
___________________________
About
Air Methods Kentucky
Air
Methods Kentucky is a full-service air medical transport system covering
Kentucky and southern Indiana.
Founded in 1982 as the first civilian air medical program in Kentucky,
in 1995 it became the first air medical program in the state to earn
CAMTS (Commission on Accreditation of Medical Transport Systems)
accreditation. It operates 10 helicopter ambulances and one
fixed wing ambulance throughout its region, with state offices
headquartered in Lexington. With a mission of safety, quality, and
integrity, Air Methods Kentucky is committed to providing its patients
and medical and emergency service partners with a high level of care and
professionalism. For more information about Air Methods Kentucky,
visit http://www.airmethodsky.com.
About
Air Methods Corporation
Air
Methods Kentucky is owned by Air Methods Corporation (NASDAQ:
AIRM),
the nation’s largest
provider of air medical emergency transport services and systems. The company is dedicated exclusively to air medical transport,
focusing on the quality of care to patients, and safety in
aviation operations. With 27 years of experience, the company transports more than
84,000 patients annually who require intensive medical care from
either the scene of an accident or general care hospitals to
highly skilled trauma centers or tertiary care centers. For
more information about Air Methods Corporation, visit http://www.airmethods.com.
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