Heart Attack Care is a Race Against the Clock

news you may not knowDoctor Buffy - Balloonologist...

It's called "door-to-balloon" time, and it's often the difference between life and death.

Yes, you're right - this is not a measure of how quickly Clarence the Clown moves from the front door to the patio, and completes his first five-legged balloon horse. As impressive as that fifth leg is, this is much more serious business.

This particular door-to-balloon time is measured from the ERs front door to the catheterization lab. The cath lab is where they perform angioplasties, a procedure in which a thin wire equipped with a small balloon is threaded through the blocked artery. Once in place, the balloon is inflated, the blood flow returns, and the damage to the heart muscle stops. Thus, the shorter the time between the front door and this critical treatment the better.

Though the recommended time is under 90 minutes, this has been a hard target to reach. But, Indiana Heart Physicians/St. Francis Heart Center (St. Francis) has shown it's possible.

St. Francis established a new procedure for dealing with heart attack patients. The first change was to allow the ER physician to activate the cath lab preparations. Previously, this required the approval of a cardiologist, and cost precious time.

The second, and possibly most significant change, was the development of a special heart attack team: the Emergency Heart Attack Response Team (EHART). This team consists of several specially trained nurses who are in-house 24/7 - no more waiting for specialists to be called in. The EHART team immediately transports the patient to the cath lab and begins preparations for the angioplasty.

The results have been spectacular. The average door-to-balloon time decreased by over 30%, from 113 minutes to 75 minutes. The average length of hospital stay decreased from 5 days to 3 days, and cost per stay is down by an average of $10,000.

But, the best news is that patients go home with less damage to their heart and a better future.

Now, where's that five-legged horse?

To read more about the study, see this from ScienceDaily. To read more about angioplasty, see this from the National Heart Lung and Blood Institute.