GPs can provide thrombolysis faster than hospitals

General practitioners have a matchless opportunity for giving thrombolytic therapy within the 90 minute "call to needle" guideline proposed by the British Heart Foundation, conclude Rawles et al (p 576), who describe call to needle times of patients with acute myocardial infarction in urban and rural areas in Grampian. In all areas general practitioners were most commonly the first medical contact, and gave opiates 30 minutes after being called. When thrombolytic treatment was given by general practitioners, median call to needle time was 45 minutes (93% within 90 minutes), but when it was deferred until after hospital admission, times were 150 minutes (5% within 90 minutes) for rural patients and about 100 minutes for urban patients. Only a minority of patients received treatment within the guideline.


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Relevant Article

Call to needle times after acute myocardial infarction in urban and rural areas in northeast Scotland: prospective observational study
John Rawles, Catherine Sinclair, Kevin Jennings, Lewis Ritchie, and Norman Waugh
BMJ 1998 317: 576-578. [Abstract] [Full Text] [PDF]

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