Experts Call for Speedier Heart Care
Hospital Care Within 90 Minutes of Arrival Cuts Risk of Heart Attack Death
6 Steps to Quicker Treatment
To design the program, Bradley and colleagues surveyed 365 hospitals for four years. They found six underused yet effective strategies to cut delays:
- Requiring the staff that performs angioplasty to be at the hospital within 20 minutes of being paged. That could save 19.3 minutes, they say.
- Having a cardiologist on site at all times; this would save 14.6 minutes.
- Having paramedics perform an ECG en route to the hospital. This could alert the ER that a person is having a heart attack and activate the angioplasty team at the hospital, for a savings of 15.4 minutes.
- Having a central operator page the angioplasty team, using a one-call system rather than having ER staff alert each individual doctor. Savings: 13.8 minutes.
- Letting ER doctors activate and prepare the procedure room for angioplasty instead of waiting for a cardiologist to review a case and decide what to do. That would save 8.2 minutes.
- Giving real-time feedback to the ER staff and those involved in the case: 8.6 minutes saved.
"With each step, we can wring out a few minutes," Bradley says.
More than 200 institutions have already joined the effort, endorsed by the National Heart, Lung, and Blood Institute, according to the researchers. Among those participating: Premier Health Care Services, Kaiser Permanente, and the Veterans Administration.
Though this program is aimed at doctors, Nissen urges the public to do their share as well.
Most people wait two hours or more before calling 911, usually due to denial, he says.
"To really make a dent in the problem, people have to act more quickly if they have signs or symptoms of a heart attack," he tells WebMD.
"Despite the fact they're suffering chest pain, they'll say it's not a heart attack. It's even a bigger problem for women, who may have symptoms that are not typical -- such as sweating or nausea," says Bradley. "We need to get people to the hospital right away."
According to the AHA, warning signs of a heart attack that rate a 911 call are:
- Chest discomfort. Most heart attacks involve discomfort in the center of the chest that lasts for more than a few minutes, or goes away and comes back. The discomfort can feel like uncomfortable pressure, squeezing, fullness, or pain.
- Discomfort in other areas of the upper body. This can include pain or discomfort in one or both arms, the back, neck, jaw, or stomach.
- Shortness of breath. This comes along with chest discomfort but can occur before such discomfort.
- Other symptoms. These may include nausea, lightheadedness, or breaking out in a cold sweat.