Door-to-balloon

door to balloon
Door-to-balloon is a time measurement in emergency cardiac care (ECC), specifically in the treatment of ST segment elevation myocardial infarction (or STEMI).wikipedia
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Percutaneous coronary intervention

coronary angioplastyPCIpercutaneous transluminal coronary angioplasty
Currently fewer than half of STEMI patients receive reperfusion with primary percutaneous coronary intervention within the guideline-recommended timeframe.
The door-to-balloon time is used as a quality measure for hospitals to determine the timeliness of primary PCI.

Emergency medical services

EMSemergency medical serviceambulance service
The program will concentrate on patient education to make the public more aware of the signs of a heart attack and the importance of calling 9-1-1 for emergency medical services (EMS) for transport to the hospital. EMS can play a key role in reducing the first-medical-contact-to-balloon time, sometimes referred to as EMS-to-balloon (E2B) time, by performing a 12 lead ECG in the field and using this information to triage the patient to the most appropriate medical facility.
In such conditions, the gold standard is the door to balloon time.

Myocardial infarction

heart attackheart attacksacute myocardial infarction
Door-to-balloon is a time measurement in emergency cardiac care (ECC), specifically in the treatment of ST segment elevation myocardial infarction (or STEMI).

Emergency department

emergency roomaccident and emergencyA&E
The interval starts with the patient's arrival in the emergency department, and ends when a catheter guidewire crosses the culprit lesion in the cardiac cath lab.

Cardiac catheterization

heart catheterizationcardiac catheterisationcardiac catheter
The interval starts with the patient's arrival in the emergency department, and ends when a catheter guidewire crosses the culprit lesion in the cardiac cath lab.

Cardiac muscle

myocardiumheart musclemyocardial
Because of the adage that "time is muscle", meaning that delays in treating a myocardial infarction increase the likelihood and amount of cardiac muscle damage due to localised hypoxia, ACC/AHA guidelines recommend a door-to-balloon interval of no more than 90 minutes.

Hypoxia (medical)

hypoxiahypoxicanoxia
Because of the adage that "time is muscle", meaning that delays in treating a myocardial infarction increase the likelihood and amount of cardiac muscle damage due to localised hypoxia, ACC/AHA guidelines recommend a door-to-balloon interval of no more than 90 minutes.

Joint Commission

JCAHOJCIThe Joint Commission
It has become a core quality measure for the Joint Commission on Accreditation of Healthcare Organizations (TJC).

Evidence-based medicine

evidence-basedmedical evidenceevidence
The D2B Alliance advocates six key evidence-based strategies and one optional strategy to help reduce door-to-balloon times:

American Heart Association

American Stroke AssociationAHAAmerican Heart Association (AHA)
On May 30, 2007, the American Heart Association launched 'Mission: Lifeline', a "community-based initiative aimed at quickly activating the appropriate chain of events critical to opening a blocked artery to the heart that is causing a heart attack."

9-1-1

911911 call9-1-1 call
The program will concentrate on patient education to make the public more aware of the signs of a heart attack and the importance of calling 9-1-1 for emergency medical services (EMS) for transport to the hospital.

Electrocardiography

electrocardiogramECGelectrocardiograph
EMS can play a key role in reducing the first-medical-contact-to-balloon time, sometimes referred to as EMS-to-balloon (E2B) time, by performing a 12 lead ECG in the field and using this information to triage the patient to the most appropriate medical facility.

Coronary catheterization

coronary angiographycoronary angiogramcardiac catheterization
This may include a "cardiac alert" or "STEMI alert" that calls in off duty personnel in areas where the cardiac cath lab is not staffed 24 hours a day.

American College of Physicians

FACPMACPMaster of the American College of Physicians
Q&A: Improving door-to-balloon time for acute MI - American College of Physicians

USA Today

USAToday.comUSA Today: The Television ShowUSAToday
"Hospitals too slow on heart attacks," USA Today, November 13, 2006. Accessed July 3, 2007.

The New York Times

New York TimesNY TimesTimes
"Hospitals Join to Speed Care After Heart Attacks," The New York Times, November 13, 2006. Accessed July 3, 2007.

ABC News

ABCABCNews.comnews
"Saving Time, Saving Lives," ABC News, November 13, 2006. Accessed July 3, 2007.

CBS News

CBSCBS Radio NewsCBSNews.com
"Heart Attack Care In Critical Condition," CBS News, November 13, 2006. Accessed July 3, 2007.

Fox News

Fox News ChannelFoxFoxNews.com
"Hospitals Seek to Speed Up Emergency Heart Attack Care," Fox News, November 13, 2006. Accessed July 3, 2007.

MSNBC

msnbc.comMSNBC Latin AmericaEqual Time
"Hospitals race to improve heart attack care," MSNBC.com, November 14, 2006. Accessed July 3, 2007.

Management of acute coronary syndrome

dual anti-platelet therapydual antiplatelet therapy
With primary PCI emerging as the preferred therapy for ST-segment elevation myocardial infarction, EMS can play a key role in reducing door-to-balloon intervals (the time from presentation to a hospital ER to the restoration of coronary artery blood flow) by performing a 12-lead ECG in the field and using this information to triage the patient to the most appropriate medical facility.