Cardiac patients 'better off in big hospital'
Heart attack patients in Roscommon should ideally have treatment in University College Hospital in Galway within 90 minutes to optimise the chances of survival, a cardiologist said yesterday.
The Galway hospital is the only facility in the west that can perform angioplasty, which can treat the acute blockage in one of the patient's arteries.
The alternative is that the patient is given clot-busting drugs at the scene by an advanced paramedic while being transported to hospital, said Dr John Barton, a cardiologist at Portiuncula Hospital in Galway.
These clot-busting drugs can only be given by an advanced paramedic or can be administered in hospitals in Sligo, Portiuncula, or Mayo General Hospital. But they cannot be administered at Roscommon hospital.
They can send an ECG from their ambulance to the hospital and doctors can direct them to give the clot-busting medicine. It only works in 60pc of cases .
The earlier a patient receives the drug the better, unless they can make it to a major hospital where they can have the angioplasty. The maximum time allowed for an artery to be opened in hospital from the first call is two hours, he added.
The HSE has said it is increasing the number of advanced paramedics working in Roscommon from next week. Dr Patrick Plunkett, consultant in emergency medicine at St James's Hospital in Dublin, said heart attack patients stood a much better chance if they got to a hospital to have the arteries opened than if they received the clot-busting drugs.
"You can only do that in a major emergency centre," he added
Asked what the advice for stroke victims was, he said the ideal was to have the patient given clot-busting drugs in a major hospital within four-and-a-half hours. If it is given within three hours, one-in-nine patients will make a significant recovery.
Referring to road accident victims, he said it was increasingly the case that fewer surgeries were being performed immediately after an accident because of improvements in CT scanning, which allows doctors to hold off on operations until later.
He said he believed people stood a better chance overall even if they had to travel a longer distance to the major emergency department.