Our local hospital has started a system which allows the ambulance crews to
request direct admission to CCU for obvious or suspected cardiac conditions.
Basically the admission criteria is any patient where the crew have, or
would have, administered Aspirin.
The door to needle times have come down dramatically.
Unfortunately I have not got the figures to hand, but if memory serves
correct, D to N time through A&E was about 60 mins and through direct
admission, 15 mins. The unit reports that the ambulance crews have been very
good at recognising cardiac conditions and only a handful of patients have
been referred to another ward.
New monitoring equipment in the hospital which uses telemetry means that a
patient arriving and being given an ECG in A&E can also be monitored in CCU.
A small portable device also allows a patient to be monitored anywhere in
the hospital.
With new digital radio systems being introduced in the ambulances which will
allow for data transmissions there is no reason, given the funding, that
ECGs could not be sent ahead and a decision made about admission while the
patient is still en-route.
Someone else mentioned moving the patient on Blues & Twos. Sorry but I think
you will find that this rarely happens. We are always taught to try and keep
the patient calm. They may use the blues but the aim is to give the pt a
smooth comfortable journey so as not to worsen their condition.
Nick Sentance
Paramedic
Lincs.
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