Health Beat

Health Beat: Heart attack: Slashing door-to-balloon times

CLEVELAND - When a heart attack happens, each passing minute can mean the difference between life and death. The goal is to get patients treatment and fast. It’s what hospitals call door-to-balloon time.

"Door-to-balloon time basically takes the time you hit the front door of the hospital to the time the device in the heart is actually opening up the blood flow," explained Dr. Travis Gullett, an emergency physician at Cleveland Clinic.

"By removing that clot as soon as possible, then the heart can come back," said Dr. Umesh N. Khot, a cardiologist also at the Cleveland Clinic.

National guidelines suggest door-to-balloon times should be 90 minutes or less for the most severe type of heart attack, known as a STEMI. Doctors at the Cleveland Clinic have been able to cut those times dramatically.

"Now, our current median time is 49 minutes," Gullett detailed.

The Cleveland Clinic's protocol standardizes criteria for the entire treatment team, including nurses, doctors, paramedics, and pharmacists. There's a detailed checklist for everyone involved with the patient's care and door-to-balloon times are posted daily.

"That really gives us a marker for how well we’re doing as a system," Gullett said.

In the first year, 100 percent of the heart attack patients were treated within the recommended 90 minutes. Thirty-five percent of patients had door-to-balloon times of 45 minutes or less. Many were treated in as little as 21 minutes.

"I think it's really changed the natural history of these types of heart attacks," Knot said.

It's a system that's saving hearts and saving lives.

Cleveland Clinic doctors hope to publish results of how their protocol is specifically impacting death rates soon. Their new door-to-balloon goal is now 45 minutes.

Hospitals around the world have contacted these doctors, asking them how they can implement similar systems.

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