TY  - BOOK
AU  - Loh, Joshua P
AU  - Sardi, Gabriel L
AU  - Satler, Lowell F
AU  - Torguson, Rebecca
AU  - Waksman, Ron
TI  - Real-time, two-way interaction during ST-segment elevation myocardial infarction management improves door-to-balloon times
SN  - 1878-0938
PY  - 2014///
KW  - *Angioplasty, Balloon, Coronary
KW  - *Myocardial Infarction/pp [Physiopathology]
KW  - Adult
KW  - Aged
KW  - Aged, 80 and over
KW  - Angioplasty, Balloon, Coronary/is [Instrumentation]
KW  - Angioplasty, Balloon, Coronary/mt [Methods]
KW  - Electrocardiography/is [Instrumentation]
KW  - Electrocardiography/mt [Methods]
KW  - Emergency Service, Hospital/ec [Economics]
KW  - Female
KW  - Humans
KW  - Male
KW  - Middle Aged
KW  - Myocardial Infarction/di [Diagnosis]
KW  - Myocardial Infarction/th [Therapy]
KW  - Telecommunications/ec [Economics]
KW  - Telecommunications/is [Instrumentation]
KW  - Time Factors
KW  - MedStar Heart & Vascular Institute
KW  - Journal Article
N1  - Available in print through MWHC library: 2002 - present
N2  - BACKGROUND: A pre-hospital electrocardiogram improves the management of patients with STEMI. Current telecommunication systems do not permit real-time interaction with the initial care providers. Our institution developed a novel telecommunications system based on a software application that permits real-time, two-way video and voice interaction over a secured network; CONCLUSION: The implementation of a two-way telecommunications system allowing real-time interactions between interventional cardiologists and referring practitioners improves overall DTB time. In addition, it has the potential to decrease the frequency of false activations, thereby improving the cost efficiency of a network's STEMI system.Copyright � 2014. Published by Elsevier Inc; METHODS: All STEMI system activations after implementation of the CHap were prospectively entered into a database. Consecutive CHap activations were compared to routine activations as controls, during the same time period; OBJECTIVES: The study aimed to determine if utilization of the CodeHeart application (CHap) reduces door-to-balloon (DTB) times of ST-segment elevation myocardial infarction (STEMI) patients; RESULTS: A total of 470 STEMI system activations occurred; CHap was used in 83 cases (17.7%). DTB time was reduced by the use of CHap when compared to controls (CHap 103 minutes, 95% CI [87.0-118.3] vs. standard 149 minutes, 95% CI [134.0-164.8], p<0.0001), as was first call-to-balloon time (CHap 70 minutes, 95% CI [60.8-79.5] vs. standard 92 minutes, 95% CI [85.8-98.9], p=0.0002). The percentage of 'true positive' catheterization laboratory activations was nominally higher with the use of CHap, although this did not reach statistical significance [CHap 47/83 (56.6%) vs. routine 178/387 (45.9%), p=0.103]
UR  - http://dx.doi.org/10.1016/j.carrev.2014.05.005
ER  -