Key result
Introduction of a dedicated EKG machine and staff feedback led to a non-significant trend toward improvement in median time to first diagnostic EKG from 22 to 10 minutes (P=0.07), with overall reperfusion times remaining longer than recommended guidelines.
Why the study?
New guidelines recommended treating STEMI within 30 minutes to thrombolysis and 90 minutes to primary PCI, prompting evaluation of how a tertiary care center compared and whether measures could shorten delays.
Does the introduction of a dedicated EKG machine and staff feedback improve reperfusion times in patients with STEMI?
Population
58 patients with STEMI in 2003-4 and 52 in 2004-5 at a tertiary care center
Comparison
Post-intervention period (staff feedback and dedicated ER EKG machine) vs initial 12-month baseline
Design
Prospectively designed audit loop using retrospective chart review
Authors
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Dedicated EKG machine alone may not improve STEMI reperfusion times; leaves open whether multifaceted interventions are required to meet guidelines.
Observational (n=110)
No
Does the introduction of a dedicated EKG machine and staff feedback improve reperfusion times in patients with STEMI?
Absolute Event Rate: 10% vs 22%
p-value: p=0.07
A prospective audit demonstrated that STEMI reperfusion times at a tertiary center were longer than ACC/AHA guidelines, and a simple intervention of a dedicated ER EKG machine did not significantly improve overall time to reperfusion.
Kaila et al. (2020) conducted an observational in ST elevation myocardial infarction (STEMI) (n=110). Dedicated EKG machine in the ER and staff feedback vs. Standard care (pre-intervention period) was evaluated on Median time from ER presentation to first diagnostic EKG (T2) in minutes (p=0.07). Introduction of a dedicated EKG machine and staff feedback led to a non-significant trend toward improvement in median time to first diagnostic EKG from 22 to 10 minutes (P=0.07), with overall reperfusion times remaining longer than recommended guidelines.
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