Editorial
Moving cardiology to the front of the hospital
| The first 150 words of the full text of this article appear below. |
The major factor influencing the outcome of thrombolytic therapy for acute myocardial infarction is the "door to needle" time. For every hour that thrombolytic treatment is delayed after the onset of symptoms, 1.6 lives are lost per 1000 patients treated.1 In many institutions the door to needle time exceeds one hour.
Various attempts have been made to reduce unacceptable treatment
delays. The most successful approach has been to shift the administration of thrombolytic treatment from the coronary care unit
(CCU) to the emergency department.2 In the study by
Hourigan and colleagues which appeared in a recent issue of
Heart,3 the door to needle
times of 100 patients treated by emergency physicians in the emergency
department were prospectively compared with those of a historical group
of 89 non-consecutive patients treated in the CCU between three years
and 16 months previously. Not surprisingly, the door to needle times in
the emergency department were much shorter than
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This article has been cited by other articles:
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Quinn, T., Weston, C., Birkhead, J., Walker, L., Norris, R., on behalf of the MINAP Steering Group,
(2005). Redefining the coronary care unit: an observational study of patients admitted to hospital in England and Wales in 2003. QJM
98: 797-802
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Goodacre, S, Kelly, A-M, Kerr, D
(2004). Potential impact of interventions to reduce times to thrombolysis. Emerg. Med. J.
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Wong, C-K, White, H D
(2002). Recognising "painless" heart attacks. Heart
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eLetters:
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- Move immediate coronary care out of the hospital into the community
- John Rawles
- Online, 11 Apr 2001 [Full text]
- Move immediate coronary care out of the hospital into the community - Authors' response
- Harvey White
- Online, 11 Apr 2001 [Full text]
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