Early screening of myocardial infarction patients before they arrive at the hospital saves valuable time and may save lives

This is according to a new study at the Soroka Medical Center published in the International Journal of Cardiology

The treatment of myocardial infarction is currently based on opening as quickly as possible the coronary artery whose blockage caused the acute attack. Such an opening can be performed by drugs that dissolve clots or by immediate catheterization and implantation of a stent at the point of blockage. Since the damage to the heart muscle increases with every minute that passes from the moment the attack begins, it is of the utmost importance that the treatment be given as quickly as possible.
Many studies have shown that the earlier the treatment is given, the more patients can be saved. The recommendations of the professional associations in cardiology are that the opening of the artery should be performed no later than 90 minutes after the patient's arrival at the hospital.
The doctors of the cardiology department at the Soroka Medical Center hypothesized that the direct transfer of myocardial infarction patients from the mobile intensive care units of the MDA (NATN) to the cardiac intensive care unit, without needing the services of the emergency room, may lead to a significant shortening of the treatment times for these critically ill patients .
A study conducted in Soroka in the years 2002-2005 does indicate that referring these patients directly to cardiac intensive care may help save their lives.
Dr. Guy Amit, Prof. Doron Zager and their colleagues in the department published their findings in the medical newspaper International Journal of Cardiology, in which they compared 115 patients who came directly to the unit through the Neten teams to 438 patients who came the usual way, through the emergency room.
The researchers report that direct transfer of the patients through the Neten teams saved an average of 37 minutes in the time that passed from the onset of pain to the opening of the artery, a difference that was statistically significant and has great clinical significance.
Shortening the treatment time is available during the day as well as at night, on weekdays as well as on weekends. The greatest shortening of time was during the daytime, when the delay time for treatment was reduced by almost a third. The researchers also found that during the study period there was a continuous decrease in the time required to open the blocked arteries, from an average of 69 minutes in 2002 to only 51 minutes in 2005.

According to Prof. Doron Zager, director of the intermediate/cardiac intensive care unit in the cardiology system in Soroka: "Although it is possible to perform a catheterization to open the artery up to 12 hours after the appearance of the signs of the heart attack, the best opportunity to save a life and reduce the damage is in the first two hours after the event. The faster the victim reaches the catheterization, the greater his chances of staying alive."

The researchers therefore come to the conclusion that the transfer of the sorting of heart patients to the MDA's netmen teams is very effective and saves valuable time in the treatment of myocardial infarction patients.
The MDA teams in the Negev region gladly accepted the challenge and when the MDA paramedics detect a myocardial infarction, they call directly to the intensive care unit in Soroka, report the patient and bring him directly to the unit, without lingering in the emergency room. In the process, the catheterization room was prepared to receive the patient as quickly as possible, so that even at night, an emergency team was called from home to treat the patient even before the patient arrived at the hospital. The experience in Soroka shows that MDA teams are almost always accurate in their diagnosis and only very rarely is a heart patient whose problem is not cardiac brought to the intensive care unit.