Relazione My e Lenti - Medici per San Ciro
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Transcript of Relazione My e Lenti - Medici per San Ciro
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Il dolore toracico E’ il piu’ frequente motivo di accesso in
PS… Ma solo il 30% dei paz con dolore toracico risulta avere una patologia grave con sca , embolia polmonare , dissezione aortica etc.##
Screening del paziente con dolore toracico
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La rete interospedaliera per l’emergenza coronarica##
E’ un network tra ospedali (a diversa compessità assistenziale) e territorio, connessi da un adeguato sistema di trasporto, che ha lo scopo di assicurare la riperfusione ottimale in tutti i pz con Ima con stategie diagnostico-terapeutiche modulate da un lato sul profilo di rischio del pz e dall’altro sulle risorse strutturali, logistiche ed economiche disponibili.
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• Ottenere il n. piu’ alto di pz riperfusi
• Usare il sistema di riperfusione piu’ idoneo in base al profilo di rischio
• Ridurre i tempi di intervento
• Migliorare la prognosi dell’ Ima
• Razionalizzare l’impiego delle risorse
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Trasferimento da centro Spoke a centro Hub
• Viene effettuato con ambulanza medicalizzata
• Viene garantita la presenza del cardiologo e dell’infermiere
• Avviene in tempi ragionevolmente brevi
• E’ eseguito in massima sicurezza
UTIC spoke nel follow up dei pazienti dopo infarto:
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• Ripresa in carico del pz subito dopo ptca
• Visite ambulatoriali di controllo
• Day hospital
• Test provocativi (test da sforzo,ecostress)
• Valutazioni cardiologiche in urgenza
Considerazioni
###Requisiti per un ottimale funzionamento della rete territoriale:
• Collaborazione tra le varie strutture • Tempesitivà degli interventi • Adesione alle linee guida ##
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American College of Cardiology/American Heart Association (ACC/AHA) guidelines specify that
primary PCI should be performed by operators who
perform 75 elective procedures per year and at least
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procedures.#European Heart Journal (2010) 31, 2501–
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TA per una corretta PCI primaria
? TAPAS F. Zijlstra, MD PhD Thoraxcenter University Medical Center Groningen, The
Netherlands
• La Trombo aspirazione migliora la riperfusione
miocardica
• La migl iore perfusione miocardica si traduce in un
beneficio clinico a 1 anno?
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