Le reti dell'emergenza in Cardiologia

l'esperienza lombarda

Translated title of the contribution: Emergency networks in cardiology: The Lombardy experience

Maurizio Marzegalli, Giancarlo Fontana, Giovanni Sesana, Niccolò Grieco, Federico Lombardi, Corrada Elena, Francesca Ieva, Anna Maria Paganoni

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Aims: To achieve a reduction of time to reperfusion through the organization of an interhospital network and the involvement of the Regional Health Authority. Methods: Four major endpoints were identified: institutional governance action, clinical management of acute ST-elevation myocardial infarction (STEMI), priority actions for cardiac arrest and early defibrillation, actions to avoid the delay related to decision-making, and logistic factors. Since 2001 in the urban area of Milan a network has been operating among 23 coronary care units, the 118 Dispatch Center (national free number for medical emergencies) and the Health Country Government Agency named Group for Prehospital Cardiac Emergency. In order to monitor the network activity and time to treatment and clinical outcomes a periodic monthly survey, called MOMI (One Month Monitoring Myocardial Infarction), was undertaken and repeated twice yearly. Data were evaluated according to hospital admission modality. Results: Global times are: symptom onset to first medical contact 116 min (interquartile range [IQR] 189), time to first ECG 7 min (IQR 12), door-to-balloon time 77 min (IQR 81.7). Non-parametric test showed that the modality of hospital admittance was the most critical determinant of doorto- balloon time. The shortest one (49.5 min) was that of patients transported by means of advanced rescue units with 12-lead ECG teletransmission and activation of a fast track directly to the cath lab. Conclusions: Our data show how in a complex urban area the organization of an interhospital network and the availability of ECG teletransmission are effective in reducing time to reperfusion, in the treatment of major arrhythmias and in pre-alert of coronary care units and cath labs in case of confirmed STEMI. This experience also stimulated an improvement in technological equipment of rescue units with extension of 12-lead teletransmission to basic life support units. Through the Health Country Government Agency and the Scientific Societies we carry on with our job to create a regional network for cardiac emergency involving all the hospitals.

Original languageItalian
JournalGiornale Italiano di Cardiologia
Volume9
Issue number10 SUPPL.1
Publication statusPublished - Oct 2008

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Cardiology
Emergencies
Government Agencies
Coronary Care Units
Electrocardiography
Reperfusion
Health
Clinical Governance
Heart Arrest
Cardiac Arrhythmias
Decision Making
Myocardial Infarction
Equipment and Supplies

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Marzegalli, M., Fontana, G., Sesana, G., Grieco, N., Lombardi, F., Elena, C., ... Paganoni, A. M. (2008). Le reti dell'emergenza in Cardiologia: l'esperienza lombarda. Giornale Italiano di Cardiologia, 9(10 SUPPL.1).

Le reti dell'emergenza in Cardiologia : l'esperienza lombarda. / Marzegalli, Maurizio; Fontana, Giancarlo; Sesana, Giovanni; Grieco, Niccolò; Lombardi, Federico; Elena, Corrada; Ieva, Francesca; Paganoni, Anna Maria.

In: Giornale Italiano di Cardiologia, Vol. 9, No. 10 SUPPL.1, 10.2008.

Research output: Contribution to journalArticle

Marzegalli, M, Fontana, G, Sesana, G, Grieco, N, Lombardi, F, Elena, C, Ieva, F & Paganoni, AM 2008, 'Le reti dell'emergenza in Cardiologia: l'esperienza lombarda', Giornale Italiano di Cardiologia, vol. 9, no. 10 SUPPL.1.
Marzegalli M, Fontana G, Sesana G, Grieco N, Lombardi F, Elena C et al. Le reti dell'emergenza in Cardiologia: l'esperienza lombarda. Giornale Italiano di Cardiologia. 2008 Oct;9(10 SUPPL.1).
Marzegalli, Maurizio ; Fontana, Giancarlo ; Sesana, Giovanni ; Grieco, Niccolò ; Lombardi, Federico ; Elena, Corrada ; Ieva, Francesca ; Paganoni, Anna Maria. / Le reti dell'emergenza in Cardiologia : l'esperienza lombarda. In: Giornale Italiano di Cardiologia. 2008 ; Vol. 9, No. 10 SUPPL.1.
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AU - Ieva, Francesca

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KW - Myocardial infarction

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KW - Public health governance

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