Focus on emergency departments to reduce delays in thrombolysis

doi:10.1136/bmj.325.7369.901/a

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C J L Hetherington, specialist registrar in emergency medicine. (hethers@doctors.org.uk),
P Doyle, consultant in emergency medicine.,
J A Kayani, consultant in emergency medicine.,
D F Gorman, consultant in emergency medicine.

Accident and Emergency Department, Selly Oak Hospital, University Hospital Birmingham NHS Trust, Birmingham B29 6JD

EDITOR—Qasim et al reported the safety and efficacy of nurse initiated thrombolysis in patients with acute myocardial infarction.— 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 …