2 Pre-hospital direct ambulance transfer has led to major improvements in timeliness of ppci in suspected stemi: temporal trends over an eight-year period in a designated PPCI centre

BackgroundThe optimal reperfusion service (ORS) protocol is a national strategy introduced in 2013 to standardize the pre-hospital care pathway for patients with ST-elevation myocardial infarction (STEMI). This protocol aimed to increase the proportion of STEMI cases directly transferred to designated primary percutaneous coronary intervention (PPCI) centres via ambulance. This evidence-based approach was implemented to improve the first-medical contact (FMC) to balloon time for STEMI cases in Ireland, as timeliness of PPCI at a national level was relatively poor as compared to international standards.AimsTo analyse temporal trends in STEMI cases arriving directly to Mater Misericordiae University Hospital (MMUH), a designated PPCI centre, following introduction of the ORS protocol; to compare FMC-to-balloon times and proportion of timely PPCI between STEMI cases arriving to MMUH via direct ambulance transfer (DAT) versus inter-hospital transfer (IHT).MethodsWe obtained retrospective data from our hospital’s STEMI database of all cases referred for PPCI between January 1st 2013 and December 31st 2020. We used the hospital’s electronic record to obtain details of mode of referral, final diagnosis, and timeliness of interventions. Timely PPCI was defined as