Emergency Physician Activation of the Cardiac Cath Lab

Time from presentation to revascularization influences infarct size and mortality in ST-segment–elevation myocardial infarction (STEMI). These authors prospectively assessed door-to-balloon times before and after implementation of a protocol mandating that emergency physicians (EPs) activate the cath lab without cardiology consultation and that a team of three registered nurses immediately transfer each patient from the emergency department to the cath lab.

Sixty consecutive STEMI patients were catheterized during the 11 months before implementation of the protocol, and 86 were catheterized during the 10 months after. Median door-to-balloon time decreased significantly overall (113.5 vs. 75.5 minutes), during regular hours (83.5 vs. 64.5 min…