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1 in 4 Americans lacks timely access to optimal care during time-sensitive medical emergencies
Date:3/17/2009

ccess to those types of facilities, according to the new study. In South Dakota, for instance, just 13 percent of the population has access within 60 minutes to an emergency department that sees three or more patients per hour; in Montana, only 8 percent do. Even in the more populous, urban Northeast, only about half of residents in Maine and Vermont can reach one of those higher-volume emergency departments within an hour. Overall, the authors found that less than half of Americans have access to a teaching hospital, which tend to offer more sophisticated treatments and be staffed by subspecialists round-the-clock, in an hour.

The nation's regionalized trauma care system allows for emergency medical service providers to bypass the closest hospital and bring severely injured patients to accredited facilities which meet specific care benchmarks. Carr suggests that this same model could be applied to care for other time-sensitive conditions like heart attack and stroke. But without any centralized inventory of emergency department capabilities or resources available at all times of day and night within individual hospitals such as a 24-hour cardiac catheterization laboratory, round-the-clock neurologic or neurosurgical expertise, or in-house critical care specialists emergency medical services planners are unable to efficiently deliver acutely ill patients to the place that is best prepared to care for them.

Time spent stabilizing and transferring patients can have dire consequences, Carr says. Following a stroke, patients must receive clot-busting drugs within three hours for the best chance at avoiding long-term cognitive or physical impairments. After a heart attack, recommendations call for a "door-to-balloon" time -- for cardiac catheterization to unblock clogged coronary arteries -- of no more than 90 minutes. And specialized care delivered following cardiac arrest, including cooling therapy and cardiac catheterization, has been shown to impr
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Contact: Holly Auer
holly.auer@uphs.upenn.edu
215-349-5659
University of Pennsylvania School of Medicine
Source:Eurekalert

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