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Questionnaire survey of thrombolytic treatment in accident and emergency departments in the United Kingdom

BMJ 1998; 316 doi: https://doi.org/10.1136/bmj.316.7127.274 (Published 24 January 1998) Cite this as: BMJ 1998;316:274
  1. Stuart Hood, registrara,
  2. David Birnie, registrarb,
  3. Lorna Swan, research fellowc,
  4. W Stewart Hillis, readerc
  1. a Department of Cardiology, Victoria Infirmary, Glasgow G42 9TY
  2. b Department of Medicine, Dumfries and Galloway Royal Infirmary, Dumfries DG1 4AL
  3. c University Department of Medicine and Therapeutics, Western Infirmary, Glasgow G11 6NT
  1. Correspondence to:Dr S Hood Department of Medical Cardiology, Royal Infirmary, Glasgow G31 2ER
  • Accepted 8 April 1997

Introduction

Numerous randomised trials have shown that thrombolytic treatment reduces mortality from acute myocardial infarction irrespective of the patient's age, sex, blood pressure, and previous history of myocardial infarction or diabetes.1 Maximum benefit, however, is seen in those patients treated within 4–6 hours of their symptoms starting. Patients do not always seek medical help soon enough, and this accounts for much of the delay in receiving thrombolytic treatment, but important delays also occur in hospital. These are not related to the route by which the patient is admitted to hospital and vary widely between hospitals.2

Although accident and emergency departments are in an important position to minimise any delay in giving thrombolytic treatment, a recent questionnaire study of junior hospital doctors in Scotland showed that thrombolysis is rarely given in accident and emergency departments there.3 We surveyed consultants in accident and emergency departments …

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