Perception about the Factors Leading to Delay of Door to Balloon Time (DTBT) in Acute Myocardial Infarction Management amongst Emergency Medical Professionals in Pune, India

Abstract

Aim: Acute Myocardial Infarction is one of the commonest medical emergencies encountered by Emergency Medical Professionals. The EMS professional is the first responder in the hospital emergency room. Primary percutaneous coronary intervention (PCI) performed in a timely manner is the preferred method of treatment for ST-elevation myocardial infarction (STEMI). This study aims to assess perception regarding factors causing delay of Door to Balloon Time (DTBT) in Acute Myocardial Infarction management amongst Emergency Medical Professionals. Study Design: Cross Sectional Descriptive Study. Place and Duration of Study: Symbiosis Centre for Health Skills, Pune in May 2021. Materials and Methods: The study was conducted amongst 120 Emergency Medical Professionals in Pune, India. The data was collected during the month of May 2021. Professionals who have completed Post Graduate Diploma in Emergency Medical Services were included in the study. A pre tested and validated questionnaire developed by Jafery et al was utilized to assess the knowledge and perception level among Emergency Medical Professionals. Results and Discussion: The study provided insight into the factors causing delay in DTBT. An overwhelming majority of respondents blamed the shortage of general and specialist staff for the delay in DTBT. Shortage of CCU beds was also reported as the key factor in the hold up by as many as 71% of the respondents. Cardiac Cath lab availability and ECG equipment shortage were considered to be hindrances by nearly half the respondents. Lack of structured protocol and poor information communication was also hampering the achievement of ideal DTBT. Conclusion: Emergency Medical Professionals have adequate knowledge of their role and the barriers that prevent timely clinical care. The study offers avenues for improvement in various clinical and non-clinical areas so as to achieve the desired clinical goals.