Cath Lab Digest - February 2008 - (Page 38)

38 STEMI INTERVENTIONS FEBRUARY 2008 A larger legislative approval process is needed to streamline the local process and to establish firm guidelines that monitor the standardized delivery of quality STEMI care to all citizens. opinion that this specific area needs urgent collaborative work from the numerous stakeholders in STEMI — individual patients and their loved ones; the community to which they belong; local healthcare facility; EMS; pharmaceutical organizations and medical device manufacturers; payers — state, local, federal, managed care and private payers; educational organizations; legislators and politicians. There are not too many in any society that will remain unaffected by heart attacks amongst members and there are few issues that will invoke a greater urgency to action — it is up to the stakeholders to formulate the best local strategy to deliver timely and optimal STEMI care. Beyond local delivery of this care, a larger legislative approval process is needed to streamline the local process and to establish firm guidelines that monitor the standardized delivery of quality STEMI care to all citizens. The author firmly believes that the perfect model to follow for a national STEMI policy58-62 is one based on the existing trauma care.63-66 Table 5 provides a comparison between acute MI and a national trauma system. Figure 2 proposes (the author’s constructed) basic nationwide STEMI triage pathway that incorporates patient activation of the EMS system, effective transport to a STEMI facility and standardized, guidelines-based delivery of the most effective STEMI treatment). ■ Dr. Mehta can be contacted at mehtas@bellsouth.net Your Online Medical Education Resource CME.NACCME.COM is a free, full-service, website available to meet your CME needs whether you’re at home, in the office or traveling. Choose a topic, participate online and print your certificate for immediate credit. Physicians, pharmacists, podiatrists, nurses, dieticians and technologists can select from a variety of accredited topics including: • Cardiology • Dermatology • Endocrinology • Oncology • Podiatry • Vascular Disease • Wound Care • General Medicine • Geriatrics By registering at CME.NACCME.COM you now have the ability to track and manage the programs you have participated in through the North American Center for Continuing Medical Education, including credits from meetings, webcasts, journal articles and supplements. You can also plan for upcoming NACCME programs with e-mail announcements and reminders in your specified areas of interest. Get started today by registering at: CME.NACCME.COM and take control of your CME. 1. Nallamothu BK, Bradley EH, Krumholz HM. Time to Treatment in Primary Percutaneous Coronary Interventions. N Engl J Med 2007;357:1631-1638. 2. Henry TD, Sharkey SW. A regional system to provide timely access to percutaneous coronary intervention for ST-elevation myocardial infarction. Circulation 2007;116:721–728. 58. Carlsson J, James SN, Stahle E, et al. Outcome of percutaneous coronary intervention in hospitals with and without onsite cardiac surgery standby. Heart 2007;93:335-338. 59. Garvey JL, MacLeod BA, Sopko G, Hand MM. Pre-hospital 12-lead electrocardiography programs: a call for implementation by emergency medical services systems providing advanced life support–National Heart Attack Alert Program (NHAAP) Coordinating Committee; National Heart, Lung, and Blood Institute (NHLBI); National Institutes of Health. J Am Coll Cardiol 2006;47:485-491. 60. Henry TD, Atkins JM, Cunningham MS. ST-segment elevation myocardial infarction: recommendations on triage of patients to heart attack centers: is it time for a national policy for the treatment of ST-segment elevation myocardial infarction? J Am Coll Cardiol 2006;47:13391345. 61. Rathore SS, Epstein AJ, Nallamothu BK, Krumholz HM. Regionalization of STsegment elevation acute coronary syndromes care: putting a national policy in proper perspective. J Am Coll Cardiol 2006;47:1346-1349. 62. Califf RM, Faxon DP. Need for centers to care for patients with acute coronary syndromes. Circulation 2003;107:14671470. 63. Cales RH, Trunkey DD. Preventable trauma deaths. A review of trauma care systems development. JAMA 1985; 254:1059-1063. 64. Pollock DA, McClain PW. Trauma registries. Current status and future prospects JAMA 1989;262:2280-2283. 65. Lowe DK, Gately HL, Goss JR, et al. Patterns of death, complication, and error in the management of motor vehicle accident victims implications for a regional system of trauma care. J Trauma 1983; 23:503-509. 66. Mullins RJ, Veum-Stone J, Helfand M, et al. Outcome of hospitalized injured patients after institution of a trauma system in an urban area JAMA 1994;271:1919–1924. References (excerpted) http://CME.NACCME.COM http://CME.NACCME.COM http://CME.NACCME.COM http://CME.NACCME.COM

Table of Contents Feed for the Digital Edition of Cath Lab Digest - February 2008

Cath Lab Digest - February 2008 Bay Regional Medical Center ENDEAVOR IV: A Zotarolimus-Eluting Stent Versus a Paclitaxel-Eluting Stent in a Randomized Clinical Trial A 3D CT Vessel “Roadmap” Over Live Fluoroscopy for Chronic Total Occlusions Contents Clinical Editor’s Corner An Evaluation of Cath Lab Turnaround Time Commentary: An Evaluation of Cath Lab Turnaround Time Excerpts from Chapter 19. STEMI Interventions – Future Perspectives The Potential Clinical Utility of Intravascular Ultrasound Guidance in Patients Undergoing Percutaneous Coronary Intervention With Drug-Eluting Stents The Ten-Minute Interview with…Debbie Charlton, RN The Society of Invasive Cardiovascular Professionals (SICP) at Transcatheter Cardiovascular Therapeutics (TCT) 2007 The Cath Lab is a Business: Do You Have the Knowledge to Stay Afloat? Incidence and Predictors of Vascular Complications after Invasive Coronary Procedures: A Prospective Analysis Ask the Clinical Instructor: A Q&A Column for those New to the Cath Lab Volunteer Survey SICP* Section Meetings Calendar What Do You Think? CEU Education Center Clinical & Industry News Classifieds Advertisers Index

Cath Lab Digest - February 2008

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