Longer journeys from east Suffolk
HEART attack patients being taken to specialist centres outside Suffolk from the east of the county take more than 40 minutes longer to get specialist treatment, according to new figures just issued.
The average “call to balloon” time for patients having an emergency angioplasty in Basildon, Norwich, or Papworth from east Suffolk is 152 minutes. The regional average is 110 minutes.
However, this delay does not seem to affect outcomes, according to a study led by the Government’s “heart tsar” Professor Roger Boyle.
This showed that the mortality rate in east Suffolk was 3.4% compared with a regional average of 4.5% and a national average of 4.2%.
The longer time was partly because of the distance between east Suffolk and the specialist centres and also because until now ambulance crews have carried thrombolysis drugs – often known as ‘clot-busting’ drugs as they help break down blood clots – which they have to administer before taking the patient to hospital. It takes several minutes to administer these drugs.
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Prof Boyle was ill with flu, so the report was presented by another member of his team, Dr Jim McLenachan, of Leeds Royal Infirmary.
He said the team was urging that thrombolysis drugs were no longer carried in ambulances because patients did better if they were taken straight to a specialist PPCI centre where angioplasty treatment (using a tiny balloon to clear a blocked artery) could be used as a first treatment.
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The situation has been under review for the last year, and during that time 94 people suffered a serious heart attack, known as a “stemi,” in east Suffolk. All were given thrombolysis treatment.
Of these, in 29 cases the thrombolysis treatment did not work effectively and they were taken straight in for PPCI treatment at one of the centres (Basildon and Papworth accepted a similar number of people from east Suffolk and a much smaller number went to Norwich).
Angioplasty cannot normally be performed within 24 hours if thrombolysis drugs work effectively.
Of the 65 who were successfully given the drugs, 42 were given angioplasty treatment the next day.
The others did not need to go forward to this treatment for various reasons.
Dr McLenachan said: “If they are given thrombolysis, [in] about a third of them, somewhere between 30 and 35% of them, the thrombolysis will fail to work and they will still require emergency angioplasty as soon as they arrive at the centre.”
Administering the thrombolysis drugs required skill, and research showed that if people were only giving thrombolysis occasionally the treatment became less effective.
Also the occasions when this would be needed would be very rare – and there was a cost implication.
He said thrombolysis drugs cost about �300 a treatment, but they had a relatively short shelf-life.
If they were carried as part of an ambulance kit they could have to be renewed 10 or 20 times before they were ever used.
After the report was published, Dr Paul Watson, chief executive of NHS Suffolk, said the PCT would be talking to senior ambulance officials about its findings on whether to continue to offer thrombolysis treatment.