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Fast-tracking of myocardial infarction by paramedics.
J R Coll Physicians Lond. 1998 Jan-Feb; 32(1):36-8.JR

Abstract

OBJECTIVE

To study the effectiveness of a fast-track method of admitting patients with myocardial infarction directly to the coronary care unit (CCU).

STUDY DESIGN

Ambulance paramedic staff were trained and provided with a Life Pak XI Monitor/Defibrillator which can obtain a 12-lead electrocardiogram. When a diagnosis of acute myocardial infarction was made by the paramedics, the CCU was informed and the patient was directly transferred to the CCU, bypassing the accident and emergency (A&E) department. The appropriateness of admission to the CCU was assessed against set criteria. The time from call for help to the administration of thrombolytic therapy (thrombolysis time) in patients directly admitted to the CCU was compared with that in another group of patients with definite myocardial infarction who were admitted through the A&E department over the same period of time.

RESULTS

Twenty-five patients were fast-tracked to the CCU. Diagnosis of myocardial infarction was confirmed on admission in 14. Thirteen were treated with thrombolysis as there were no contra-indications; of the other 11 patients, seven were diagnosed as angina, one had complete heart block, one had haemodynamically significant atrial fibrillation and two had non-cardiac chest pain. The average time from call for help to thrombolysis in this group was 82 +/- 32 minutes. This was significantly shorter (p < 0.02) than in the patients who were admitted through A&E, in whom the average time from call for help to thrombolysis was 112 +/- 35 minutes. Twenty-one of 25 fast-tracked patients fulfilled the criteria for CCU admission.

CONCLUSION

The majority of fast-trackings are appropriate and will result in quicker administration of thrombolysis in hospitals where the facility for thrombolysis does not exist in the A&E department.

Authors+Show Affiliations

Department of Cardiology, Barnsley District General Hospital.No affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

9507439

Citation

Banerjee, S, and W E. Rhoden. "Fast-tracking of Myocardial Infarction By Paramedics." Journal of the Royal College of Physicians of London, vol. 32, no. 1, 1998, pp. 36-8.
Banerjee S, Rhoden WE. Fast-tracking of myocardial infarction by paramedics. J R Coll Physicians Lond. 1998;32(1):36-8.
Banerjee, S., & Rhoden, W. E. (1998). Fast-tracking of myocardial infarction by paramedics. Journal of the Royal College of Physicians of London, 32(1), 36-8.
Banerjee S, Rhoden WE. Fast-tracking of Myocardial Infarction By Paramedics. J R Coll Physicians Lond. 1998 Jan-Feb;32(1):36-8. PubMed PMID: 9507439.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Fast-tracking of myocardial infarction by paramedics. AU - Banerjee,S, AU - Rhoden,W E, PY - 1998/3/21/pubmed PY - 1998/3/21/medline PY - 1998/3/21/entrez SP - 36 EP - 8 JF - Journal of the Royal College of Physicians of London JO - J R Coll Physicians Lond VL - 32 IS - 1 N2 - OBJECTIVE: To study the effectiveness of a fast-track method of admitting patients with myocardial infarction directly to the coronary care unit (CCU). STUDY DESIGN: Ambulance paramedic staff were trained and provided with a Life Pak XI Monitor/Defibrillator which can obtain a 12-lead electrocardiogram. When a diagnosis of acute myocardial infarction was made by the paramedics, the CCU was informed and the patient was directly transferred to the CCU, bypassing the accident and emergency (A&E) department. The appropriateness of admission to the CCU was assessed against set criteria. The time from call for help to the administration of thrombolytic therapy (thrombolysis time) in patients directly admitted to the CCU was compared with that in another group of patients with definite myocardial infarction who were admitted through the A&E department over the same period of time. RESULTS: Twenty-five patients were fast-tracked to the CCU. Diagnosis of myocardial infarction was confirmed on admission in 14. Thirteen were treated with thrombolysis as there were no contra-indications; of the other 11 patients, seven were diagnosed as angina, one had complete heart block, one had haemodynamically significant atrial fibrillation and two had non-cardiac chest pain. The average time from call for help to thrombolysis in this group was 82 +/- 32 minutes. This was significantly shorter (p < 0.02) than in the patients who were admitted through A&E, in whom the average time from call for help to thrombolysis was 112 +/- 35 minutes. Twenty-one of 25 fast-tracked patients fulfilled the criteria for CCU admission. CONCLUSION: The majority of fast-trackings are appropriate and will result in quicker administration of thrombolysis in hospitals where the facility for thrombolysis does not exist in the A&E department. SN - 0035-8819 UR - https://www.unboundmedicine.com/medline/citation/9507439/Fast_tracking_of_myocardial_infarction_by_paramedics_ L2 - https://medlineplus.gov/heartattack.html DB - PRIME DP - Unbound Medicine ER -