Door-to-balloon

Door-to-Balloon Time

Prehospital ECG transmission for STEMI patients

Door-to-balloon time (D2B) is a critical measure in the treatment of ST-Elevation Myocardial Infarction (STEMI), a severe form of heart attack. It refers to the time interval from a patient's arrival at the hospital to the moment they receive percutaneous coronary intervention (PCI), specifically balloon angioplasty.

Importance

Reducing door-to-balloon time is crucial because the sooner a blocked coronary artery is opened, the better the patient's chances of survival and recovery. The American College of Cardiology and the American Heart Association recommend a door-to-balloon time of 90 minutes or less.

Process

The process of minimizing door-to-balloon time involves several coordinated steps:

• Prehospital ECG Transmission: As shown in the image, prehospital electrocardiogram (ECG) transmission allows emergency medical services (EMS) to send ECG results to the hospital before the patient arrives. This enables the hospital team to prepare for immediate intervention.

• Emergency Department Protocols: Upon arrival, the patient is quickly assessed and diagnosed. If STEMI is confirmed, the patient is rapidly transferred to the catheterization laboratory.

• Catheterization Laboratory Activation: The catheterization team is alerted and prepared to perform PCI as soon as the patient arrives.

Strategies to Reduce Time

Hospitals employ various strategies to reduce door-to-balloon time, including:

• Streamlined Communication: Effective communication between EMS, emergency department staff, and the catheterization lab team is essential.

• Prehospital Notification: EMS can notify the hospital of an incoming STEMI patient, allowing the catheterization lab to be ready upon the patient's arrival.

• Standardized Protocols: Implementing standardized protocols for STEMI treatment helps ensure that all team members know their roles and responsibilities.

Challenges

Despite efforts to reduce door-to-balloon time, challenges remain, such as:

• Geographical Barriers: Patients in rural areas may face longer transport times to hospitals equipped with PCI facilities.

• Resource Limitations: Not all hospitals have 24/7 access to a catheterization lab, which can delay treatment.

Related Pages

• Myocardial Infarction
• Percutaneous Coronary Intervention
• Electrocardiogram
• Emergency Medical Services