ubiquitin – I responded to your post earlier not sure why it disappeared, I will respond once again.
You mentioned two examples, strokes and heart attacks. The time windows you posted are correct, yet the context is incorrect.
Heart attacks, true hospitals have door to balloon or door to cath time, yet this by no means represents patient outcome. Time is muscle and minutes matter. If there is an occlusion in one of the blood vessels supplying the heart, the heart is getting injured and dying. the earlier that is taken care of and reperfused means fewer chances of the patient going into cardiac arrest or having permanent chronic heart failure (basically means less dead muscle or less dead meat in their chest).
Hospitals have ‘heart stats’ and ‘MI teams’ that are activated by EMS on the field, these patients are of the highest priority in the emergency room, they bypass all the normal procedures and are usually immediately are taken to the cardiac cath lab, no one sits around waiting even just one minute. Everyone knows that every wasted minute means more dead cells.
Paramedics can diagnose some heart attacks, they can activate the cath lab from the patients home so that the team in the hospital can begin prepping for the procedure. they can also initiate first-line treatment all the while the ambulance is pushing traffic to get to the patients home. which is why a grass routes EMS response makes a lot of sense. All of this reduces the overall time from onset until treatment and without doubt results in better patient outcomes.
Strokes, true there is a 3 hour window (or 4+ hour window that some comprehensive stroke centers have adopted) yet this is just for the cut off time, basically it means that once the patient is out of the time window the risks of administering tPA overweigh and is withheld. By no means does this mean that time is not of the essence.
Time is brain, every minute that elapses more cells die, EMS will usually make a stroke notification, neurology will await them at the door, the CT scanner will be cleared upon EMS’s notification, these patients are immediately taken to the scanner and treated. Everyone knows that minutes matter, minutes are what make a difference between no or minor neurological deficits versus major irreversible deficits. Minutes are what make the difference between a favorable and unfavorable outcome.
Besides, the time window is just for ischemic strokes, with hemorrhagic strokes, these patients are bleeding out and can have increased intracranial pressure, all in a matter of minutes, these are very high priority patients that usually require immediate airway management and neurosurgery.
Please do not state publicly that minutes do not matter when it comes to heart attacks and strokes, they do! If anyone is experiencing any symptoms of a heart attack or stroke they should immediately without delay call whichever EMS they prefer.