Beyond D2B times: critical global issues in STEM! interventions

摘要

In Europe and North America, D2B interventions no longer present formidable logistical challenges. Almost entirely, D2B times <90 min are being achieved. This has resulted from reliable prehospital activation and from team work [9]. The Joint Commission on Accreditation of Healthcare Organizations mandates, financial incentives and legal threats have also contributed to the improvements. However, D2B times may be an oversimplification for providing optimal STEM I care. They may be a wrong metric, a pseudo-scientific measure that is prone to manipulation and criticism. Worse, it may even have unintended consequences. Beyond these fundamental flaws, achieving D2B time simply represents the low hanging fruit of STEMI interventions; the larger challenges include patient education and legislation [l].