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Text
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<a href="http://doi.org/10.1016/j.jemermed.2013.08.089" target="_blank" rel="noreferrer noopener">http://doi.org/10.1016/j.jemermed.2013.08.089</a>
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Pages
734-740
Issue
5
Volume
46
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Title
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DOOR-TO-BALLOON TIMES FROM FREESTANDING EMERGENCY DEPARTMENTS MEET ST-SEGMENT ELEVATION MYOCARDIAL INFARCTION REPERFUSION GUIDELINES
Publisher
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Journal of Emergency Medicine
Date
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2014
2014-05
Subject
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care; Emergency Medicine; freestanding emergency department; global registry; hospital; infarction; interhospital transfer; mortality; percutaneous coronary intervention; perspective; primary angioplasty; randomized-trials; ST-segment elevation myocardial; system; united-states
Creator
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Simon E L; Griffin P; Medepalli K; Griffin G; Williams C J; Hewit M; Lloyd T S
Description
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Background: Freestanding emergency departments (FEDs) introduce a challenge to physicians who care for the patient with an ST-segment elevation myocardial infarction (STEMI) because treatment is highly time dependent. FEDs have no percutaneous coronary intervention (PCI) capabilities, which necessitates transfer to a PCI-capable facility or fibrinolysis. Study Objective: Our aim was to determine the proportion of STEMI patients who arrived to an FED and were subsequently transferred for PCI and met the door-to-balloon reperfusion guidelines of 90 min. Methods: This was a dual-center retrospective cohort review of all patients 18 years and older who were diagnosed with an STEMI and presented to the main hospital-affiliated FEDs. Electronic medical records and emergency medical services documentation were reviewed for all cases since the opening of the FEDs in July 2007 and August 2009, respectively. Key time points were abstracted and statistical evaluation was performed using Fisher's exact test. Results: A total of 47 patients met inclusion criteria. Median door-to-transport time was 34 min (inter-quartile range [IQR] 15 min). Median transport time from the FEDs to the main hospital catheterization laboratory was 21 min (IQR 5 min). Median arrival at the catheterization laboratory-to-balloon time was 25 min (IQR 13 min). Median total door-to-balloon time was 83 min (IQR 10.5 min), with 78.7% meeting the American Heart Association's recommended guidelines of <= 90 min. Conclusion: STEMI patients initially seen at two FEDs achieved door-to-balloon time goals of < 90 min. (C) 2014 Elsevier Inc.
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<a href="http://doi.org/10.1016/j.jemermed.2013.08.089" target="_blank" rel="noreferrer noopener">10.1016/j.jemermed.2013.08.089</a>
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Journal Article
2014
care
Emergency Medicine
Freestanding emergency department
global registry
Griffin G
Griffin P
Hewit M
Hospital
Infarction
interhospital transfer
Journal Article
Journal of Emergency Medicine
Lloyd T S
Medepalli K
Mortality
percutaneous coronary intervention
perspective
primary angioplasty
randomized-trials
Simon E L
ST-segment elevation myocardial
system
united-states
Williams C J