Reducing Door-to-Balloon Time Using EMS-Initiated App-Based Communication

Author Department

Cardiology; Medicine

Document Type

Article, Peer-reviewed

Publication Date

7-2024

Abstract

Background: Reducing door-to-balloon (D2B) time for ST-segment elevation myocardial infarction (STEMI) has been shown to improve outcomes. Delays still occur due to various factors such as time to laboratory activation and diagnostic clarification in equivocal cases. We propose that early communication through a mobile application (app) between emergency medical services (EMS) and in-hospital providers can reduce EMS-to-balloon time and provide coordinated care to impact D2B time.

Methods: The General Devices e-Bridge mobile app, which allows real-time communication and data transmission between EMS providers and the cardiac catheterization laboratory and emergency department staff, was implemented on May 14, 2019. A single-center, retrospective observational study was conducted on 795 STEMI activations undergoing emergent coronary angiography between January 2017 and July 2020. After exclusions, EMS transmissions of 428 cases were analyzed, of which 132 used the app.

Results: Implementation of e-Bridge significantly reduced D2B time by 7.2 minutes (P = .005) and emergency department board time by 4.41 minutes (P = .01). First medical contact to balloon (FMC2B) time trended toward reduction but was not statistically significant. The app did not significantly reduce D2B or FMC2B time during the day shift but significantly improved these metrics during the night shift.

Conclusions: Implementation of app-based communication between EMS and in-hospital providers resulted in statistically significant reductions in D2B time at our institution. This approach holds promise in improving the timely management of STEMI patients, particularly during the night shift.

Keywords: ST-segment elevation myocardial infarction; app; door-to-balloon time; first medical contact to balloon time.

PMID

39575209

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