BMJ 2002;325:901 ( 19 October )

Letters

Focus on emergency departments to reduce delays in thrombolysis

The first 150 words of the full text of this article appear below.

EDITOR---Qasim et al reported the safety and efficacy of nurse initiated thrombolysis in patients with acute myocardial infarction.1 The stepwise improvement in thrombolysis times over the three phases is impressive and a credit to the medical and nursing staff of the coronary care unit. We hope that phase 4 will continue to show improvement, enabling the 2003 national service framework targets to be met.

The emergency department gets merely a cursory mention in the context of reasons and causes of delays in treatment. It seemed not to be deemed important in streamlining the management of patients with acute myocardial infarction. Yet during phase 1 it was one of the "two main reasons" for delays identified.

Phase 2 does not address this problem. Patients with suspected acute myocardial infarction in the emergency department were transferred to the coronary care unit for further assessment by a nurse. Presumably the patient had already seen a . . . [Full text of this article]
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Relevant Article

Quality improvement report: Safety and efficacy of nurse initiated thrombolysis in patients with acute myocardial infarction
Asif Qasim, Kerry Malpass, Daniel J O'Gorman, and Mary E Heber
BMJ 2002 324: 1328-1331. [Abstract] [Full Text] [PDF]

Rapid Responses:

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Focus on EDs to reduce delays in thrombolysis
Ian K Dukes
bmj.com, 23 Oct 2002 [Full text]
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