Myocardial Ischaemia National Audit Project - University College ...

Figure 26. Part 2 collected by Cardiac Rehabilitation TeamData set V9Part 2 – REHAB Data set V9Part 2 – REHAB NB: All fields marked with # should be completed to achieve 100% on Data Completeness.NB: All fields marked with # should be completed to achieve 100% on Data Completeness. NB: All fields marked with # should be completed to achieve 100% on Data Completeness.NB: All fields marked with # should be completed to achieve 100% on Data Completeness.be offered further investigations and also have the opportunityto be seen by the Cardiac Rehab team prior to discharge.When Part 1 is complete the data is passed over to the CardiacRehabilitation team who will collect the remaining information(Figure 26) with regards to discharge medication, rehab advice,any referrals for investigation/interventions etc. Once completethis form is passed to our Information Services departmentwho enter the data for us.11. St George’s Hospital’s pPCI ServiceDr Maciej Marciniak – Specialist RegistrarDr Pitt O Lim - Consultant CardiologistDepartment of Cardiology, St George’s Hospital, LondonThe major determinant of good outcome in MI is early coronaryrevascularisation. Hence the challenge is increasing publicawareness for symptoms and signs of MI so that those whoare having an MI will “call for help” as soon as possible. Theambulance service then takes the patients to designated HeartAttack Centres (HAC) for emergency primary percutaneouscoronary intervention (pPCI). The occluded coronary arteryis unblocked with a balloon and the culprit segment ofthe coronary artery is stented. This “call to balloon” timetherefore describes the patient journey from home to thecardiac catheter laboratory. It is a marker of the robustness ofambulance service and hospital set up, this duration closelyand inversely correlates with survival and outcome of MI. TheDanish researchers demonstrated that each hour delay isassociated with a 10% reduction in survival (Terkelsen andcolleagues JAMA 2010; 304: 763).The pPCI service at St George’s Hospital (SGH) has been inplace since October 2005 covering the population in the southwest of London with the help of the London Ambulance Service(LAS), and the service was extended to Surrey from May 2006with the help of the South East Coast Ambulance Service(SECAMB). As it takes longer for patients to journey fromSurrey to St George’s Hospital, we have installed the LIFENETsystem whereby an ECG can be wirelessly transmitted to ourCoronary Care Unit (CCU) for confirmation of MI prior to thejourney which can take up to 45 minutes.MINAP Eleventh Public Report 201293