open access

Vol 4, No 2 (2019)
Research paper
Published online: 2019-08-06
Get Citation

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

Marcin Przybylowicz1, Magdalena Wawrzynska2
·
Disaster Emerg Med J 2019;4(2):42-49.
Affiliations
  1. Paramedic, Specialist Hospital of Henryk Klimontowicz in Gorlice, Poland
  2. Department of Emergency Medical Service, Laboratory of Experimental Medicine and Innovative Technology, Wroclaw Medical University, Wroclaw, Poland

open access

Vol 4, No 2 (2019)
ORIGINAL ARTICLES
Published online: 2019-08-06

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.

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.

Get Citation

Keywords

ST-segment elevation myocardial infarction; STEMI; Emergency Medical Services; teletransmission ECG

About this article
Title

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

Journal

Disaster and Emergency Medicine Journal

Issue

Vol 4, No 2 (2019)

Article type

Research paper

Pages

42-49

Published online

2019-08-06

Page views

673

Article views/downloads

522

DOI

10.5603/DEMJ.2019.0009

Bibliographic record

Disaster Emerg Med J 2019;4(2):42-49.

Keywords

ST-segment elevation myocardial infarction
STEMI
Emergency Medical Services
teletransmission ECG

Authors

Marcin Przybylowicz
Magdalena Wawrzynska

References (20)
  1. Goncerz G, Leśniak W, Referowska M. Proceeding in acute myocardial infarction with elevation of the ST segment. Summary of the guidelines of the European Society of Cardiology 2017. Practical Medicine — Cardiology — special edition. 2018; 1: 20–42.
  2. Strzelecki Z., Szymborski J. (ed.), Morbidity and mortality of cardiovascular diseases and the demographic situation of Poland, Government Population Council, Warsaw 2015; 6. https://bip.stat.gov.pl/files/gfx/bip/pl/zamowieniapubliczne/426/248/1/81_gp_rrl_2015_monografia_kardiologiczna.pdf (16.02.2019).
  3. Czukowska-Milanova L, Rychlak P. Acute coronary syndromes. In: Gucwa J, Ostrowski M. ed. Advanced resuscitation and selected emergencies. Practical Medicine, Cracow 2018: 139.
  4. Arntz H, Bellou A, Beygui F, Bossaert LL, Cariou A, Nikolaou NI. Preliminary proceedings in acute coronary syndromes. In: Andres J, Bellou A, Beygui F, Bossaert LL, Cariou A, Nikolaou NI. ed. Resuscitation Guidelines. Polish Resuscitation Council, Cracow 2015: 335.
  5. The Act of 8 September 2006 on State Emergency Medical Services, art. 24., Dz.U. 2006 nr 191 poz. 1410.
  6. Filip D, Górski A, Ozga D, et al. Analysis of the functioning of emergency medical teams in the operational area of the Provincial Emergency Service Station in Rzeszów in 2012. Anestezjologia i Ratownictwo. 2016; 10: 280–283.
  7. Aftyka A, Rudnicka-Drożak E. Causes of calls from medical emergency teams in the material of the Provincial Emergency Service of the Social Welfare Center in Lublin. Anestezjologia i Ratownictwo. 2013; 7: 392.
  8. Bates ER, Bogai A, Dauermann HL, et al. Emergency Department Bypass for ST-Segment–Elevation Myocardial Infarction Patients Identified With a Prehospital Electrocardiogram: A Report From the American Heart Association Mission: Lifeline Program. Circulation. 2013; 128: 352–359.
  9. Bednarz K, Chrzanowska-Wąsik M, Goniewicz M, et al. Cases of acute coronary syndrome – analysis of interventions of emergency medical services teams. Journal of Education, Health and Sport. 2017; 7(4): 589–591.
  10. Agewall S, Antunes MJ, Bucciarelli-Ducci C, et al. ESC Guidelines for the management of acute myocardial infarction with ST segment elevation in 2017, transl. P. Cardiology Poland. 2018; 76(2): 235–251.
  11. Anderson JL, Morrow DA. Acute Myocardial Infarction. N Engl J Med. 2017; 376(21): 2053–2064.
  12. http://www.aisn.pl/pracownie/baza_pracowni (6.04.2019).
  13. Maeng M, Sorensen JT, Terkelsen CJ, et al. System delay and mortality among patients with STEMI treated with primary percutaneous coronary intervention. JAMA. 2010; 304(7): 763–771.
  14. Fudalej P, Gogolewski G, Kleszczyński J. Drugs used in the basic syndrome. In: Kleszczyński J, Zawadzki M. ed. Drugs in rescue medicine. PZWL, Warsaw 2017: 217.
  15. Kąsiel-Ziarkowska E. Diagnosis of acute coronary syndrome. Analysis of trips of medical emergency teams. Na Ratunek. 2017; 3: 11.
  16. Karyś J, Karyś T, Słoma K, et al. Knowledge of medical rescue teams on the management of acute syndromes. Zdrowie i dobrostan. 2015; 1(XXV): 48–349.
  17. Ładny JR. Update of the position of a national consultant in the field of emergency medicine. Treatment of patients with ACS in the pre-hospital period - a summary and commentary to the recommendations for emergency medical teams. Na Ratunek. 2018; 3: 51–55.
  18. Regulation of the Minister of Health of 20 April 2016 on medical rescue operations and health services other than medical rescue operations that may be provided by a paramedic. Dz.U. 2016 poz. 587.
  19. Przybylski A, Terejko E. Changes in pre-hospital treatment in acute coronary syndromes after the introduction of new guidelines. In: Skrok M. ed. Selected aspects of workin medical emergency. Marcin Skrok Publishing House, Wielkie Radowiska 2018: 12.
  20. Ahlsson A, Alfonso F, Banning AP, et al. 2018 ESC/EACTS Guidelines on myocardial revascularization. European Heart Journal. 2019; 40(2): 144.

Regulations

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

By VM Media Group sp. z o.o., ul. Świętokrzyska 73, 80–180 Gdańsk, Poland
tel.:+48 58 320 94 94, fax:+48 58 320 94 60, e-mail: viamedica@viamedica.pl