Galway University Hospitals leading the way in coronary care procedure

More than 50 heart attack patients have been transferred by helicopter to Galway University Hospitals (GUH ) in the past six months.

The HSE West says University Hospital Galway is a convenient and accessible site for the aeromedical service as the landing pad is based on the hospital grounds.

“This means that the emergency crew can transport a patient into the hospital for treatment much more quickly than in some of the other centres where the landing pad is not on the hospital grounds,” says a spokesperson.

GUH has been leading the way in providing an emergency 24-hour heart-attack treatment programme, formally known as primary percutaneous coronary intervention or PPCI, since last October.

This non-surgical procedure is the gold standard treatment for a full-blown heart attack and is used to treat the narrowed or blocked coronary arteries found in heart disease. Recent international evidence has shown PPCI to be the most effective treatment for a major heart attack.

The programme has been rolled out nationally since January as part of the HSE’s national acute coronary syndrome programme. GUH has led the way as the first hospital to go live in October 2012 providing a seven day week 24 hour service. Professor Kieran Daly, a consultant cardiologist at GUH is the national clinical leader of the initiative.

The cardiology intervention team at Galway comprises a number of consultant cardiologists, medical staff, cardiac technicians, cardiology nurses and radiographers and is supported by other healthcare professionals.

GUH was one of six hospitals designated as a primary PCI centre based on having a catheter laboratory available together with the required number of cardiologists trained in PPCI. GUH is now receiving patients from throughout the west with many being transported by the Air Corps Medevac 112 helicopter as part of the emergency aeromedical service.

Under the 24/7 service any patient with an acute heart attack within 90 minutes of travel time to Galway is brought straight to the hospital where they receive emergency treatment in the cardiac catheter laboratory. This involves a minimally invasive procedure under local anesthetic to open blocked arteries using a balloon catheter and stents to stop heart attacks. If outside this travel time, the patient is taken to the nearest hospital emergency department for thrombolysis or clot-breaking drugs and then urgently transferred to GUH.

The HSE West says the ambulance service has been pivotal in the success of this programme. “Through their assessment of a patient, including evaluation of the heart tracing or ECG, they determine the appropriate treatment strategy. The ‘heart attack team’ in GUH is activated and the patient is transferred directly for the emergency procedure.”

Dr Briain MacNeill, a consultant interventional cardiologist at GUH, explains that when a full-blown heart attack, known as a STEMI, is identified there are two treatment options.

“If the ambulance service can get to GUH within 90 minutes of travel time then the patient will be brought directly to the hospital for the PPCI procedure. The ambulance service may also call on the emergency aeromedical service if the flight time including pick-up is within the 90 minute travel time. The national ambulance service has direct access to the cardiology team on call and can update the hospital on patient conditions on route and expected arrival time.”

Over the past year Galway University Hospitals has treated patients from not only the western counties but also from Sligo, Leitrim, Donegal, Limerick, Tipperary, Offaly, Longford and Westmeath, as well as people on holidays from the US, Canada and France.

The aim of the Acute Coronary Syndrome Programme is to improve and standardise the care of patients that experience heart attacks. As part of the programme ambulances are equipped and paramedics trained to recognise a major heart attack and to transport the patients to the best place for appropriate care.

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