Monday, 9 January 2012

Prince Philip and the #NHS


Prince Philip was admitted to Papworth hospital on Xmas Eve having suffered an episode of chest pain. He went on to receive a coronary stent within hours of admission. It is likely therefore that he suffered a ST elevation myocardial infarct (STEMI) or heart attack. It has been suggested in the blogosphere that he received a standard of treatment most plebs would not have received. A STEMI is diagnosed with an on site ECG that is performed by the paramedics.  Until a few years ago, the gold standard of treatment for patients suffering a STEMI was to give an intravenous injection of a clot buster or thrombolysis within 3-4 hours of onset of chest pain. This would dissolve the clot blocking the coronary artery at the site of a narrowing and a full blown potentially fatal heart attack averted. A few years ago, evidence start to emerge that if patients were taken within 3-4 hours straight to the cardiac catheterisation lab, a coronary angiogram performed and the offending blockage in the coronary artery removed mechanically and a coronary stent used to reopen the narrowing, the results were even better than thrombolysis. Getting the cath (catheterisation) lab (not present in all hospitals) and all the staff (who are not resident) ready within 60 minutes of a call several times a night is logistically challenging. I personally thought that it could never happen on a large scale . The above graph from Anglia Strategic Health Authority shows that the percentage of STEMIs or heart attacks treated with Primary Percutaneous Intervention  or PPCI (which is what the procedure is called) has gone from 0% to just under 100% in 2 years These figures are quite extraordinary & have been reproduced around the country (and can be found here). They do represent a triumph for the NATIONAL health service and show that Prince Philip received treatment 90+% would have received.