rnaden1
Registered: 11/07/07
Posts: 1
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Reply with quote | #1 |
Hi Cath Lab friends,
I am looking for info on door to balloon times for pts and staff. If you established d2b, what are your protocols. I have read that some hospitals have done d2b, but stopped. Thanks Roberta
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ferretpants
Moderator
Registered: 01/05/07
Posts: 31
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taylor110
Registered: 28/07/07
Posts: 1
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Reply with quote | #3 |
Our Labs policy is that the staff has 30 min from time of page to be in the lab and ready to recieve the pt. For our pts we follow a d2b time benchmark of < than 90 min. from initial diagnosis of an MI, to re-perfusion
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ferretpants
Moderator
Registered: 01/05/07
Posts: 31
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Reply with quote | #4 |
Our door to balloon time for patients is 24mins average.
We are given 30mins also to come in, but most of us stay on-site, hence the cracking average above.
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clotbuster
Registered: 24/11/07
Posts: 3
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Reply with quote | #5 |
Hi, we have been pushing for C2B (call to balloon) of 120 minutes, we have found it is of little point for us to break our backs getting to the lab, if the pre-hospital times are excessive, improving the pre-hospital times hopefully gets the whole system working. Previously we could easily see 60mins+ prehospital times, this is now down to 25-30mins.
The problem we currently have is that the trust has two large hospitals, the one with the A&E (and therefore the most acute admissions) doesn’t have the cath lab, so we would need to transfer 3 miles up the road to get PCI. We have found that this causes too much delay, and as a result rely on thrombolising. We can get PCI only really mon / fri 9-5, and crew take directly to the PCI site.
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ferretpants
Moderator
Registered: 01/05/07
Posts: 31
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Reply with quote | #6 |
Anyone out there also offering a 24/7 Primary service?
What I really mean to say is "Who has cardiologists who can be bothered to get out of bed?"
Because at the end of the day this is the reason why most places won't go 24/7
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clotbuster
Registered: 24/11/07
Posts: 3
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Reply with quote | #7 |
We have vast differences acros the contry (UK), some now only offer PCI, mainly in London. The service in our county is basically 9-5, mon-Fri. We do have some guidelines set out in the National Service framework NSF, but most refer to thrombolysis times. I think the biggest problem is getting the Cardiologist out during the night - largely as the rotas currently expect a one in 5/6, and they are still expected to be doing a ward round or cath list a 8/9am the following day. So I can't blame them for not taking it forward. They will get come out if Lysis has failed or there are other underlying problems, but they are the exception rather than the rule. |
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ferretpants
Moderator
Registered: 01/05/07
Posts: 31
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Reply with quote | #8 |
Hi clotbuster
Thats great that you feel sympathy for your cardiologists, but lets flip this on it's head. It's out of hours and you develop a major ST elevation busting MI, what would you rather have: thrombolysis or Primary PCI?
Is there a 24/7 cath lab you can go to near you?
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clotbuster
Registered: 24/11/07
Posts: 3
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Reply with quote | #9 |
I would rather lysis, than a tired cardiologist at the other end of a 3 foot piece of plastic that is wedged in my left main!
Granted we all think PCI is probably the better option, and while it is all going well it probably is, but in the wrong hands, it can go belly up very quickly.
Lets face it no one is 100% at 3am, having just been in bed 30minutes ago , we need to arrange adequate overnight cover if we are going to do it, with organised sleep time etc.  |
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ferretpants
Moderator
Registered: 01/05/07
Posts: 31
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Reply with quote | #10 |
Interesting take on things clotbuster, given all the liturature around supporting PPCI against lysis. In the many years we have been doing PPCI I can't say I have noticed too many tiredness induced errors, maybe there is some papers on this somewhere, or data to start one!?
Though I support your case if you have very fresh inexperienced consultants. Battle hardened consultants usually do this stuff in their sleep anyway.
What are other peoples view on this ?
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rradognaRN
Registered: 17/04/08
Posts: 1
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Reply with quote | #11 |
OUR DOOR TO BALLOON TIME IS 90 MINUTES, STAFF HAS 30 MINUTES TO GET TO THE HOSPITAL |
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stevebaldeo
Registered: 02/02/09
Posts: 1
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