All patients in the invasive facility were prospectively documented in a dedicated database.
With the network implementation the number of initial EMS transfers to the peripheral hospital markedly decreased whereas the number of direct transfers to the invasive facility from the catchment area of the non-invasive hospitals increased as did the number of back transfers to the peripheral hospitals.
Network structures include 12-lead ECG in the ambulance, ECG telemetry to the intensive care unit of the invasive facility, a structured phone call between emergency medical services (EMS) and the intensive care physician on call and preparation of the cathlab before patient arrival.
There must be a better way than to build expensive, environmentally invasive facilities in places with no culture of sliding sports.
Ellis, CJ, Devlin, G, Matsis, P, Elliott, J, Williams, MJ, Gamble, G, Mann, S, French, J, White, H, Lennane, J, and al, E. "Acute Coronary Syndrome patients in New Zealand receive less invasive management when admitted to hospitals without invasive facilities". New Zealand Medical Journal 117, no.
However, in specialized centers with invasive facilities the intracoronary route might be an option for patients with cardiogenic shock refractory to standard care.
Ipswich Hospital has secured £5m to build an invasive cardiology facility.
Founded in 1966, the Duke Lemur Center (DLC) is an internationally acclaimed non-invasive research facility housing nearly 240 animals across 17 species – the world's largest and most diverse population of lemurs outside their native Madagascar.
As an undergraduate at the University of California, Santa Cruz (Go Banana Slugs! – best mascot ever!), I was extremely fortunate to work at a non-invasive research facility that was associated with the University.
Two teaching hospitals with invasive treatment facilities on site refused to participate.
Therefore, even in situations e.g. in developing area where endoscopic (minimally invasive) surgical facilities are not available, open surgery remains a reasonable option.
