Benchmarking Ambulance Call-to-needle Times for Thrombolysis of Acute Myocardial Infarction in Victoria

Kelly, A.-M.

doi:10.1197/aemj.9.5.377

Cited by 10 publications

(11 citation statements)

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“…If a patient cannot reach a hospital within 90 minutes, out-of-hospital thrombolysis should be considered (37). Use of pre-hospital thrombolytic therapy has been suggested not only in rural communities but also in urban areas where traffic congestion may contribute to the delay (12).…”

Section: Discussionmentioning

confidence: 99%

Pain to Hospital Times After Myocardial Infarction in Patients from Dalmatian Mainland and Islands, Southern Croatia

et al. 2010

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Aim To analyze pre-hospital delay in patients with myocardial infarction from mainland and islands of Split-Dalmatian County, southern Croatia. MethodsThe study included all patients with myocardial infarction transported by ambulance to the University Hospital Split in 1999Split in , 2003Split in , and 2005. Pre-hospital delay was analyzed in the following intervals: pain-to-call, call-to-ambulance, ambulance-to-door, and door-to-coronary care unit interval. Patients were categorized according to the location from which they were transported: Split, mainland >15 km from Split, and islands.Results There were 1314 patients (62.9% men) transported and hospitalized for myocardial infarction. Total prehospital delay (pain-to-hospital) was significantly reduced from 1999 to 2005 (5.2 hours vs 4.3 hours, P = 0.011). Seventy-five patients (5.7%) were admitted to the coronary care unit within the recommended time-frame of less than 90 minutes, none of which was from the islands, while 248 patients (18.9%) were admitted more than 12 hours from the onset of pain.

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Section: Discussionmentioning

confidence: 99%

Pain to Hospital Times After Myocardial Infarction in Patients from Dalmatian Mainland and Islands, Southern Croatia

et al. 2010

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“…11 Moreover, a state-wide study looking at call-to-needle (CTN) time-the time period between first notification by the patient and commencement of therapyacross Victoria, reported that only 61 per cent of patients received thrombolysis within the benchmark CTN time of 90 minutes and a CTN time of >90 minutes was associated with greater mortality (relative risk, 1.8). 13 Hence, it appears that despite having well-established and specific guidelines regarding the treatment of STEMI, national use of timely reperfusion remains poor and incomplete in practice.…”

Section: Treatment Modalities and Clinical Outcomes Of Metropolitan Amentioning

confidence: 99%

Acute coronary syndrome in Australia

Nadel¹,

Hewitt²,

Horton³

2017

AMJ

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“…[13][14][15] A 20% increase in EMS use from a baseline of 49% was also projected, based on the maximum potential improvement in EMS use observed in the randomized trial setting. 17 (2) Increasing PPCI services was assessed by evaluating the effect of establishing 10 new PPCI facilities (representing a substantial [~25%] increase in the total number of PPCI facilities) in the most densely populated areas without existing proximate (≤120 minutes driving time) PPCI facilities.…”

Section: Interventions To Improve Timely Access To Reperfusionmentioning

confidence: 99%

“…These estimates are derived from published Australian data. [13][14][15] We assumed that patients who self-refer have the same driving time as those using EMS. The hospitals were then stratified into PPCI and fibrinolysis facilities, allowing estimation of the proportion of adult Australians for whom a PPCI or fibrinolysis facility was the nearest hospital.…”

Section: Baseline Analysismentioning

confidence: 99%

Comparative Effectiveness of Population Interventions to Improve Access to Reperfusion for ST-Segment–Elevation Myocardial Infarction in Australia

Ranasinghe

Turnbull

Tonkin

et al. 2012

Circ: Cardiovascular Quality and Outcomes

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Background-Improving timely access to reperfusion is a major goal of ST-segment-elevation myocardial infarction care. We sought to compare the population impact of interventions proposed to improve timely access to reperfusion therapy in Australia. Methods and Results-Australian hospitals, population, and road network data were integrated using Geographical Information Systems. Hospitals were classified into those that provided primary percutaneous coronary intervention (PPCI) or fibrinolysis. Population impact of interventions proposed to improve timely access to reperfusion (PPCI, fibrinolysis, or both) were modeled and compared. Timely access to reperfusion was defined as the proportion of the population capable of reaching a fibrinolysis facility ≤60 minutes or a PPCI facility ≤120 minutes from emergency medical services activation. The majority (93.2%) of the Australian population has timely access to reperfusion, mainly (53%) through fibrinolysis. Only 40.2% of the population had timely access to PPCI, and access to PPCI services is particularly limited in regional and nonexistent in remote areas. Optimizing the emergency medical services' response or increasing PPCI services resulted in marginal improvement in timely access (1.8% and 3.7%, respectively). Direct transport to PPCI facilities and interhospital transfer for PPCI improves timely access to PPCI for 19.4% and 23.5% of the population, respectively. Prehospital fibrinolysis markedly improved access to timely reperfusion in regional and remote Australia. Conclusions-Significant gaps in timely provision of reperfusion remain in Australia. Systematic implementation of changes in service delivery has potential to improve timely access to PPCI for a majority of the population and improve access to fibrinolysis to those living in regional and remote areas. (Circ Cardiovasc Qual Outcomes. 2012;5:429-436.)

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Benchmarking Ambulance Call-to-needle Times for Thrombolysis of Acute Myocardial Infarction in Victoria

Cited by 10 publications

References 0 publications

Pain to Hospital Times After Myocardial Infarction in Patients from Dalmatian Mainland and Islands, Southern Croatia

Pain to Hospital Times After Myocardial Infarction in Patients from Dalmatian Mainland and Islands, Southern Croatia

Acute coronary syndrome in Australia

Comparative Effectiveness of Population Interventions to Improve Access to Reperfusion for ST-Segment–Elevation Myocardial Infarction in Australia

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