Navigation Links
RACE: a statewide model of better, faster heart attack care
Date:11/4/2007

ORLANDO, FL A North Carolina team of doctors, nurses, hospitals and emergency medical service workers has come up with a way to provide faster, more effective treatment for heart attack patients.

It doesnt require expensive drugs or fancy new equipment. But it does require competitors to become collaborators, and it calls on everyone involved to move treatment forward empowering emergency services personnel in the field to diagnose a heart attack, something only physicians had done before.

Working as partners, rather than as rivals, the team, led by clinicians at Duke University Medical Center, was able to dramatically slash the time from diagnosis to treatment with potentially life-saving therapies, especially in the area of transfers into and out of smaller, feeder hospitals.

Results of the two-year project, called RACE (Reperfusion of Acute Myocardial Infarction in North Carolina Emergency departments), were presented today at the annual meeting of the American Heart Association.

Heart disease is the number one killer in North Carolina, and this program resulted in patients being treated faster and more effectively with life-saving care, said Dr. Christopher Granger, a cardiologist at Duke University Medical Center and a lead investigator of the project. While several other, smaller, city-wide health systems like Boston and Minneapolis have mounted similar efforts, this is the first to demonstrate dramatic system-wide improvement on a statewide scale. We are so encouraged by the results that we feel the RACE system may be a model for change throughout the rest of the country.

There are three times as many deaths from heart attacks as there are from car accidents, said Dr. James Jollis, a cardiologist and senior author of the study. But while we have a trauma system to take care of accident victims, we dont have any sort of system to take care of people who suffer heart attacks.

Design of the RACE project was based on a trauma system. It involved caregivers at 65 hospitals and associated emergency medical teams throughout North Carolina. Participants were divided into five regions Greenville, Durham, Winston-Salem, Charlotte and Asheville. Everyone focused on a single goal to provide the fastest, most beneficial care to the greatest number of heart attack patients eligible for reperfusion, or artery-opening therapy. Reperfusion therapies include clot-dissolving drugs and blood thinners as well as a surgical procedure called angioplasty that uses slender catheters carrying balloons and stents to prop open blocked vessels.

Physicians in the RACE program credit the decision to move care forward with much of the programs success. Moving care forward means enabling first responders to do as much of the work as possible. To that end, paramedics were trained to do the work of emergency room physicians and emergency room physicians were trained to do the work of cardiologists. A single phone call from the field was enough to bring an angioplasty team to the catheterization lab, and hospitals had to admit heart attack patients, even if they didnt have any beds. Cardiologists had to give up some of the control we were used to having, says Jollis. It was a hard habit to break. But once we saw the results, we knew we could trust the process.

Over the two years of the program, physicians collected information on 2,000 patients, measuring pre and post-intervention times for key processes: the time from when the patient arrives at the hospital door to either angioplasty or clot-busting therapy, and the time it takes for a patient at a feeder hospital to enter and leave the transferring hospital, and the time a patient enters a feeder hospital to treatment at a second, receiving hospital. Times improved substantially in all areas.

  • Median time from door to treatment for hospitals offering angioplasty fell from 85 to 74 minutes. (22 percent)

  • Median time from door to infusion of clot-busting therapy fell from 35 to 29 minutes. (17 per cent)

  • Median time from door-in to door-out at transfer hospitals fell from 120 to 71 minutes. (41 per cent)

  • Median time from arriving at a feeder hospital to beginning treatment at a receiving hospital fell from 149 minutes to 106 minutes. (29 per cent)

Studies show that heart attack patients treated with reperfusion therapies within 90 minutes do best. But many people who are eligible to get these treatments dont get them in time, or dont get them at all, says Jollis. Now, we know how to change that.


'/>"/>

Contact: Michelle Gailiun
michelle.gailiun@duke.edu
919-724-5343
Duke University Medical Center
Source:Eurekalert

Related medicine news :

1. The sleep race: White, wealthy, and sleep-wise
2. Indians Make One Major Human Race: US Study
3. Another Statewide Organization Joins the Fight Against Assisted Suicide
4. Novel computer model for breast cancer
5. MRI, To Detect Remodeling Of Heart and Help Preserve Function
6. Down syndrome simulated in animal model after successful chromosome transplantation
7. Synthetic protein found to relieve arthritis symptoms in animal model
8. Researchers Develop Mouse Model Of Brain Tumor
9. New Model for understanding Tumor Metastasis
10. Mathematical Model Can Now Help Predict Asthma Risk
11. Model Kate Moss - Re-Birth After Humiliation
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:10/13/2017)... ... October 13, 2017 , ... As health professionals work to improve ... engagement.” The patient is doing more than filling out a survey; in many cases ... an increasing emphasis in health care and research on the importance of active engagement ...
(Date:10/13/2017)... Nevada (PRWEB) , ... October 13, 2017 , ... ... Hemp CBD Oil utilizing Purzorb™ technology. Applying the Purzorb™process to full spectrum CBD oil ... required and providing a CBD form that can be easily incorporated into liquid products, ...
(Date:10/13/2017)... OBISPO, Calif. (PRWEB) , ... October 13, 2017 , ... ... or dementia. However, many long-term care insurance companies have a waiver for care if ... the 90-day elimination period, when the family pays for care, is often waived, so ...
(Date:10/13/2017)... ... ... Yisrayl Hawkins, Pastor and Overseer at The House of Yahweh, has released a ... books in the Holy Scriptures, Revelation. The Book of Revelation paints a picture of ... have tossed it off as mere rubbish, but Yisrayl Hawkins says that is because ...
(Date:10/13/2017)... ... October 13, 2017 , ... “America On The Brink”: the Christian history ... The Brink” is the creation of published author, William Nowers. Captain Nowers and ... WWII veteran, he spent thirty years in the Navy. Following his career as ...
Breaking Medicine News(10 mins):
(Date:9/27/2017)... Sept. 27, 2017  DarioHealth Corp. (NASDAQ: DRIO), a leading global digital ... its MyDario product is expected to appear on The Dr. Oz Show ... Oz Show airs in your area: http://www.doctoroz.com/page/where-watch-dr-oz-show ... The nine-time Emmy award-winning, The Dr. Oz Show kicked off ... The segment features ...
(Date:9/23/2017)... -- Janssen Biotech, Inc. (Janssen) announced today that it ... Food and Drug Administration (FDA) for the Biologics License ... of moderately to severely active rheumatoid arthritis (RA). The ... to further evaluate the safety of sirukumab in the ... "We are disappointed by ...
(Date:9/19/2017)... , Sept. 19, 2017 HistoSonics, Inc., a venture-backed medical device company developing ... of targeted tissues, announced three leadership team developments today:   ... ... ... Veteran medical device executive Josh Stopek ...
Breaking Medicine Technology: