The proceedings of medical emergency teams with patients with acute myocardial infarction with an elevation of ST-segment in the Gorlice county

Abstract

INTRODUCTION: Ischaemic heart disease and myocardial infarction are the main cause of morbidity and mortality in western civilizations. In the broad definition of ischaemic heart disease is a disease entity which is STEMI. It is a life-threatening condition that can lead to cardiac arrest in a short time. The development of knowledge and treatment systems has contributed to a significant decrease in-hospital mortality as a result of STEMI, however, the total mortality because of this disease has practically not decreased, because about 2/3 of deaths occur in the pre-hospital period before the patient receives reperfusion therapy. Therefore, it is so important to regularly analyse the rescue procedure and modernize solutions aimed at improving the survivability of these people. The aim of the study is to evaluate the proceeding of emergency medical teams in patients with acute myocardial infarction with ST elevation on the ECG.

MATERIAL AND METHODS: The Rescue Orders Cards and Medical Rescue Operations Cards of emergency medical teams operating in the Gorlice county in the period from 01.01.2016 to 31.12.2017 were used for the study. There were identified cases in which diagnosis from group I21 according to ICD-10 was made and all other cases in which patients were transported directly to the haemodynamic regardless of the diagnosis made, and in whom in ECG was diagnosed STEMI. The study was carried out based on the analysis of medical documentation of the Emergency Service in Gorlice. A type of Desk Research analysis was also used to review the available literature and research results of other authors from recent years.

RESULTS: Analysis of the research material showed that: –– statutory criteria of reach time to the patient were met in 68.3% of cases, –– 51.14% of patients with STEMI symptoms call on EMS after 2 hours from their occurrence, –– 89.36% of patients with STEMI were transported directly to the haemodynamic, –– the median from diagnosis of STEMI to hand over in cases of transport the patient to the haemodynamic was 65 minutes, –– two-stage antiplatelet treatment is used in 47.87% of cases.

CONCLUSIONS: The time of reach EMS to the patient with STEMI is in most cases within the limits of the statutory standard. Most of the patients with STEMI symptoms delay call an ambulance by more than 2 hours. The vast majority of patients with a diagnosis STEMI get directly to the haemodynamic while meeting the assumed time criterion of 100 minutes. The frequency of anticoagulant and antiplatelet drug therapy is not in line with current recommendations. In most cases paramedics use ECG tele-transmission.