1. Mid and South West Wales Primary Angioplasty update
SE Cardiac Network meeting 02/3/2012
Dr Stephen Dorman, Morriston Cardiac Centre

3. All comer regional PPCI service 31/10/2011
24/7 PPCI service to ABMU, HD and Powys patients within 90 minute travel time of Morriston” (by air or land ambulance)
PPCI workload now doubled ~ 41 PPCI’s per month ( i.e ~ 500 PPCI’s p.a, ~ 500 PPCI p.m.p )
High quality service
Benefits realisation
Reduced L.O.S at referring hospitals
Reduced transfer times for routine ACS transfers

7. Geographic distribution of PPCI cases by home postcode Oct 2011- Jan 2012 ( Courtesy SM & AR)

8. Quality standards – Door to Balloon time

9. Quality standards – Call to balloon

10. Outcome data
2.5% (3/122) 30 day mortality

11. ~ 50% reduction in total length of stay for STEMI patients
Substantial reductions in L.O.S Data from WWG, first 44 days of PPCI, 14 repatriations
~ 50% reduction in total length of stay for STEMI patients
5-6 day mean LOS with local lysis & convalescent transfer vs
3 day mean LOS with PPCI
Anedotal data
Average (days)
Median
Morriston
1.3 1
GGH
2.1 2

12. Local patients – Mean LOS 4.0 days
Length of Stay n= 122 patients – between 31/10/2011 and 20/02/2012 (LW informatics)
Local patients – Mean LOS 4.0 days
Repatriated patients – Mean LOS 3.4 days
73% of patients staying 3 days or less

13. Ongoing work Accurate 12 lead ECG interpretation
Need to identify funding for Telemetry
Education sessions
Fine tuning operational protocols – WAST/ Secondary/MCC
Increasing Air ambulance utilisation for remote areas
Repatriation pathways – Bed protection
All Wales agreement on pre hospital drug therapy
Audit and monitoring of data through MINAP / BCIS
Improved discharge information including Cardiac Rehabilitation
Communications to patients and public