Designated fast tract improving the treatment of patients with ST elevation myocardial infarction
Research Article entitled “Designated fast tract improving the treatment of patients with ST elevation myocardial infarction” was written by the author Saban Mor.
He is working as the Faculty of Health and Welfare Sciences in University of Haifa, Haifa, Israel.
Introduction of Article:
Time delay from cardiac symptoms onset to reperfusion in patients presenting with (STEMI) is a major factor for poor prognosis [1-8]. STEMI is defined as class I indication for door to balloon time (DTBT) to initiate percutaneous coronary intervention (PCI) within 90 minutes [9-12]. Customarily, patients admitted to emergency departments (ED) with chest pain should be undergone a rapid triage assessment and highpriority scoring [13-16]. However, in almost half of the cases, these patients are withholding and receiving a lower priority score, therefore delayed from STEMI diagnosis and PCI treatment on time [15,16]. Several triage classification tools are used in EDs to determine the patient urgency [15-17]. In Israel, the most common tool is the Canadian Triage and Acuity Scale (CTAS). According to CTAS, patients who were classified as P1 requires immediate treatment, while patients who were classified as P2 to P5, are expected to receive medical assessment and treatment within 15, 30, 60 and 120 minutes, respectively. Ultimately, patient with STEMI should be classified in P1 or P2 category. Few studies have further shown a significant reduction in DTBT for patients correctly classified by the nurses' triage. Yet, these studies did not assess the whole triage process which include further than patient’s urgency classification, time lags to ECG, to physician and to troponin blood test results.
The results indicated a significant improvement in critical quality indicators, namely, DTBT, time to triage and ED assessment factors. The ‘fast-track’ program for patients with chest pain in ED provides early diagnosis of STEMI and shortened waiting times for coronary reperfusion catheterization. These findings have prominent contribution and significant implications on the quality of care for patients with chest pain attending at ED. The findings of this research encourage further interventions of its kind and are a basis for developing tools for identifying patients attending with chest pain to achieve better outcomes in the critical ED assessment stages.
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