Systems of Care to Improve Timeliness of Reperfusion Therapy for ST-Segment Elevation Myocardial Infarction During Off HoursThe Mayo Clinic STEMI Protocol
David R. Holmes, Jr, MD, FACC,
Malcolm R. Bell, MBBS, FACC,
Bernard J. Gersh, MB, ChB, DPhil, FACC,
Charanjit S. Rihal, MD, MBA, FACC,
Luis H. Haro, MD,
Christine M. Bjerke, RN,
Ryan J. Lennon, MS,
Choon-Chern Lim, BS,
Henry H. Ting, MD, MBA, FACC*
Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota.
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Figure 2 Door-to-Balloon Times at Saint Marys Hospital and for Transfers from Regional Hospitals and Door-to-Needle Time at Regional Hospitals
(A) Door-to-balloon time for patients presenting to Saint Marys Hospital treated with primary percutaneous coronary intervention (PCI) during off hours compared to regular hours. (B) Door-to-balloon time for patients presenting to regional hospitals transferred for primary PCI during off hours compared to regular hours. (C) Door-to-needle time for patients presenting to regional hospitals treated with fibrinolysis during off hours compared to regular hours.
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Figure 3 Time Intervals at Saint Marys Hospital and Regional Hospitals for PCI and Time Intervals at Regional Hospitals for Fibrinolysis
(A) Comparison of pre-specified time intervals comprising total door-to-balloon time for patients presenting to Saint Marys Hospital treated with primary percutaneous coronary intervention (PCI) during off hours compared to regular hours. (B) Comparison of pre-specified time intervals comprising total door-to-balloon time for patients presenting to regional hospitals transferred for primary PCI during off hours compared to regular hours. (C) Comparison of pre-specified time intervals comprising total door-to-needle time for patients presenting to regional hospitals treated with fibrinolysis during off hours compared to regular hours. ECG = electrocardiography.
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Figure 4 Door-to-Balloon Time During Regular Hours and Off Hours Before and After Implementing Protocol
(A) Door-to-balloon time for patients presenting to Saint Marys Hospital treated with primary percutaneous coronary intervention (PCI) during regular hours before and after implementation of the ST-segment elevation myocardial infarction (STEMI) protocol. (B) Door-to-balloon time for patients presenting to Saint Marys Hospital treated with primary PCI during off hours before and after implementation of the STEMI protocol.
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