Heart attack victims attended to quicker

PHOTO: Heart attack victims attended to quicker

SINGAPORE- Doctors are streamlining hospital procedures to cut waiting times for heart attack patients, a critical step in reducing permanent injury and death from one of Singapore's top killers.

Simple procedures such as placing equipment bags at the ready in operating theatres, rather than storing them in cupboards, have allowed Tan Tock Seng Hospital to shave precious minutes off the "door to balloon time" - the period from when the patient is rushed through hospital doors to when he has an angioplasty to unblock his artery.

At TTSH, a patient now waits an average of 60 minutes, 10 minutes faster than in 2010. The hospital hopes to eventually cut this to 45 minutes. The international standard is 90 minutes.

Two major heart centres have used similar measures to cut waiting times. At the National Heart Centre Singapore, a patient waits about an hour, down from 80 minutes in 2007; a patient at the National University Heart Centre Singapore waits an average of 52 minutes, down from 68 minutes.

Several doctors from TTSH spoke about the hospital's experience to 270 cardiologists from the region at a conference last weekend. One of its improvements has been to place all equipment such as syringes and gauze into a single large bag rather than individually sealed pouches.

"Now, everything is prepared," said Adjunct Assistant Professor David Foo, head of the arrhythmia, pacing and electrophysiology service at the cardiology department. "In the past, everything was individually packed and the nurses had to open them one by one."

Equipment bags are also placed on trolleys in operating theatres rather than in cupboards. This means nurses walk only nine steps to treat each patient rather than 39.

Almost 9,000 people suffered heart attacks here in 2012, and 1,210 died. TTSH saw more than 400 heart attack patients last year. The hospital also relocated its invasive cardiac laboratory - where angioplasties are done - to above the emergency department last year.

The lab was previously situated at the opposite end of the hospital, said Prof Foo, and it would take up to 10 minutes of running with the patient on a trolley to get there.

"Now, once the patient is out of the emergency department, they end up on our doorstep," he said.

Hospital staff also used to have to collect patients' property before they went into surgery, a process that could take longer than expected.

Dr Paul Ong, a senior consultant at the TTSH cardiology department, said: "There was one case... the uncle had lottery tickets. They had to document every single lottery ticket number before sending him up (to surgery)."

Now, all of a patient's belongings are placed into a single sealed bag before the patient is moved into surgery.


This article was first published on Aug 6, 2014.
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