Coronary Heart Disease (CHD) is the leading cause of death in the UK, despite rates falling; mortality varies, with highest rates in the West of Scotland.

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Primary angioplasty is widely recognised as the gold standard treatment for acute ST segment elevation myocardial infarction, when it can be performed within mandated times.

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Across Scotland a significant number of patients are excluded from receiving primary PCI due to their geographical location in relation to the PCI centres and transportation constraints. Scotland therefore has operated an optimal reperfusion service, providing both primary PCI and thrombolysis with immediate transfer to a PCI centre.

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The collaboration between PCI centres and the ambulance service aimed to ensure that all appropriate patients, suitable for optimal reperfusion, received prompt therapy, either pPCI or thrombolysis, within local, regional & national guidelines. Transfers are audited locally against national targets.

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Challenges remain for the ambulance service in achieving diagnosis to mobilisation within the proposed 20 minute window.

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Transmission of 12 lead ECGs direct from the pre-hospital setting, to PCI centres, allows supported clinical decision making in immediate management, for ambulance service and hospital staff.

 

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