United States Is #1 In Something Else Awesome: Heart Attack Care
If you live in the United States, you're basically in the best possible spot in the world... if you end up having a heart attack.
According to recent reports, a record-setting 93 percent of patients now receive treatment for a heart attack within 90 minutes of arrival at the hospital. That is a marked improvement from even a decade ago when less than half of the patents received treatment that quickly.
Time Is Muscle
The procedure most people require when they're experiencing a heart attack is called angioplasty. During the procedure, doctors guide a tube through a blood vessel in the groin or an arm to the blockage causing the heart attack. A tiny balloon is inflated to flatten the clog and leave behind a mesh tube called a stent to prop the artery open. The sooner blood flow is restored, the less chance there is of permanent damage to the heart and surrounding tissue.
"It's one of the few things in medicine where time, literally seconds, is of the essence. It's where the phrase 'time is muscle' comes from," said Dr. Ajay Kirtane, director of the lab that performs angioplasties at New York-Presbyterian/Columbia University Medical Center.
Picking Up Speed
U.S. guidelines have long recommended that someone needing an angiogram should be treated within 90 minutes of arriving at the hospital. The risk of dying goes up 42 percent if care is delayed even half an hour beyond those guidelines. Because the "door-to-balloon" time averaged a dismal 96 minutes in 2005, the American College of Cardiology began a drive to get hospitals to improve. A new study recently found that it now averages only 59 minutes.
UConn John Dempsey Hospital in Farmington, Connecticut reported a median door-to-balloon of only 39 minutes during one recent quarter. According to the hospital's EMS coordinator Peter Canning, one reason UConn is so fast is the fact that they've made their emergency responders part of the cardiac care team.
"We used our paramedics to extend our hospital into the patient's home, where they do an extensive electrocardiogram of the heartbeat and call results ahead to the hospital to get the angioplasty room ready," he said. "Calling from 25 minutes out instead of 5 minutes out can be a savings of 20 minutes of the heart muscle."