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Critical analysis of Percutaneous coronary intervention (PCI) Merseyside region (North west ambulance service) - Essay Example

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PCI in Merseyside region Name Institution Tutor Date PCI in Merseyside region Introduction The United Kingdom reports about 275,000 cases of a heart attack annually and between a third and two thirds of deaths occur outside the hospital. Many of these deaths occur within the first few minutes after the first symptoms are reported…
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Critical analysis of Percutaneous coronary intervention (PCI) Merseyside region (North west ambulance service)

Download file to see previous pages... In 2007, the North West Ambulance Service introduced these standards for the management of pre-hospital cardiac chest pain. The policy outlined three approaches for managing acute cardiac chest pain, which are thrombolysis, and percutaneous coronary intervention (PCI). This is the widening of the coronary artery using a catheter to dilate the artery and fixing a metallic stent to keep it open. Most paramedic services offer PCI as the first choice treatment, and it is gaining preference over thrombolysis. However, the non-uniformity in the provision of PCI forces clinicians to use several options for treating patients with cardiac chest pain (Department of Health, 2008). A feasibility study conducted by the department of health and national societies concluded that the introduction of Primary PCI was desirable, feasible, and cost effective. More than 70 percent of STEMI cases are treated by PPCI, and the service targets 100 percent of the eligible cases. This has been achieved through the collaborative work of NHS and other multidisciplinary teams. The increasing utilization of PCI has led to the decline on thrombolysis since PCI is considered to be more efficient and safer. Pre-hospital thrombolysis requires a joint 60 minute call to needle target, which is a challenge to ambulance services (Barnes, Carpenter and Dickinson, 2006). ...
PCI is usually performed on stable patients with AMI who have not received thrombolysis. Several studies have indicated a reduction of mortality in patients with AMI who have received PCI. These patients also have less chances of developing stroke or non-fatal reinfarction than those treated with thrombolytic therapy. Patients with STEMI have a superior and long term benefits of transfer for primary angioplasty after receiving PCI and these benefits are experienced for up to three years (Lin, Dudlev and Redberg, 2008). Patients who receive PCI at a door-to-balloon time of less than 90 minutes have a 90 percent chance of survival or improvement. PCI provides the fastest means possible for effective reperfusion for patients suffering from STEMI. The number of cases requiring traditional emergency revascularization methods such as CABG has reduced due to better and safer PCI procedures. PCI is performed within a shorter time than CABG, which makes it more efficient (Department of Health 2008). PCI is compatible with other revascularization methods such as thrombolysis and CABG. This can occur at the same time or as part of the revascularization strategy. In women, patients suffering from acute MI have a better response to PCI than fibrinolysis. In a PAMI trial, women who received PCI had a 4 percent mortality rate compared to 14 percent in those who received fibrinolysis. Moreover, women receiving fibrinolysis have increased rates of major bleeding and intracranial hemorrhage (Devlin, Appleby and Buxton, 2007; Counsell et al, 2007). However, women who receive PCI have a one-year mortality rate making it more beneficial. Women experiencing recurrent ACS and have abnormal biomarkers have lower mortality after receiving PCI. Patients with recurrent ACS or MI ...Download file to see next pagesRead More
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