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Ambulance-to-ER care critical for heart attacks

Coordinated effort between hospitals and emergency services in N.C. improved survival rates for heart attack patients


DURHAM, N.C. — RACE-ER (Reperfusion of Acute Myocardial Infarction in Carolina Emergency Departments – Emergency Response) is the largest voluntary statewide heart attack care intervention ever undertaken in the United States. Thousands of health care professionals from North Carolina’s 119 hospitals collaborated with more than 500 emergency service agencies across 53,000 square miles.

From July 2008 through December 2009, RACE-ER decreased the time from first contact to medical treatment from 103 minutes to 91 minutes when patients were brought directly to hospitals that performed angioplasty, now known as percutaneous coronary intervention (PCI). Of those patients, 52 percent were treated within 60 minutes.

Treatment times for patients transferred from non-PCI hospitals to PCI centers improved from 117 minutes to 103 minutes. Thirty-nine percent of transferred patients were treated within 90 minutes by December 2009. "Our intervention demonstrates how competing healthcare entities can work together to overcome the systematic barriers that prevent timely heart attack treatment," says James Jollis, a Duke University cardiologist and first author of the findings published in the journal Circulation. "We were able to embed a standard of care that was independent of what hospital the patient was brought to or where the heart attack occurred."


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