Halo 194 (Jan 2018)
Treating acute coronary syndrome in the municipal institution for emergency medical aid - Belgrade, Serbia
Abstract
Introduction. Treating patients suffering from acute myocardial infarction with ST elevation (STEMI) represents a challenge and new treatment possibilities with better outcomes are always sought. The Emergency Medical Aid Service holds the key role in prehospital care of patients with STEMI and administers dual antiplatelet therapy: MONA (Morphine, Oxygen, Nitroglycerin, Aspirin) + clopidogrel or ticagrelor, with the aim of enhancing the reperfusion effect. Objective: To determine the incidence of prehospital treatment of STEMI with dual antiplatelet therapy, as well as the time passed from the first contact with the 194 operator to the admission of the patient to the hospital. Methods: Retrospective analysis of the period between January 1st 2014. and December 31st 2017. The diagnosis was based on medical history as described by the patient, clinical findings and ecg tracings. In patients diagnosed with STEMI, dual antiplatelet therapy was administered and monitored. Time passed from the first contact with the 194 operator to admission to the hospital was also measured. Results: Out of the total number of 8843 patients with acute coronary syndrome, who were treated by the Emergency Medical Aid Service, 2982 were diagnosed with STEMI. Dual antiplatelet therapy was administered to 40.29% of the patients in 2014, while that percentage grew to 70.01% in 2017. Of that percentage in 2017, 60.38% received MONA and ticagrelor, while 9.63% received MONA and clopidogrel. Women have been proven to suffer from STEMI at a later age (70.17±13.05 years of age) than men (61.89±13.43 years of age). Also, 75% of the patients are admitted to the hospital within 65.77 minutes from the moment of the first contact with the 194 operator. Conclusion: During the period in question, a significant rise in application of antiplatelet therapy has been noted. The transfer time of STEMI patients is an important factor of prehospital treatment. Continuous education of Emergency Medical Aid teams enables advances of diagnostic and therapeutic measures in prehospital conditions. .
