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Why I'm needled by thrombolysis target

BMJ 2002; 325 doi: (Published 19 October 2002) Cite this as: BMJ 2002;325:911
  1. David Geggie, specialist registrar in accident and emergency medicine. (
  1. Countess of Chester Hospital, Chester

    Up and down the United Kingdom emergency departments are in crisis (again!) with senior managers and medical staff burning the midnight oil. The reason for this increased activity is the government's national service framework (NSF) for coronary heart disease ( At present, the guidelines on thrombolysis in acute myocardial infarction are that 75% of patients should receive thrombolysis (“door to needle time”) within 30 minutes. Many emergency departments currently struggle to reach these targets. However, these guidelines are due to change to 75% of patients receiving thrombolysis within 20 minutes by April 2003. This is not going to be easy to achieve and there are increased funds available from the Department of Health (as well as the potential for penalties for failure) in order that these targets are met. Many departments are looking at employing extra staff and using more expensive “bolus thrombolytics” in order to meet these targets. …

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