| Fast-tracking of myocardial infarction by paramedics. | |
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MedLine Citation:
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PMID: 9507439 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To study the effectiveness of a fast-track method of admitting patients with myocardial infarction directly to the coronary care unit (CCU). STUDY DESIGN: Ambulance paramedic staff were trained and provided with a Life Pak XI Monitor/Defibrillator which can obtain a 12-lead electrocardiogram. When a diagnosis of acute myocardial infarction was made by the paramedics, the CCU was informed and the patient was directly transferred to the CCU, bypassing the accident and emergency (A&E) department. The appropriateness of admission to the CCU was assessed against set criteria. The time from call for help to the administration of thrombolytic therapy (thrombolysis time) in patients directly admitted to the CCU was compared with that in another group of patients with definite myocardial infarction who were admitted through the A&E department over the same period of time. RESULTS: Twenty-five patients were fast-tracked to the CCU. Diagnosis of myocardial infarction was confirmed on admission in 14. Thirteen were treated with thrombolysis as there were no contra-indications; of the other 11 patients, seven were diagnosed as angina, one had complete heart block, one had haemodynamically significant atrial fibrillation and two had non-cardiac chest pain. The average time from call for help to thrombolysis in this group was 82 +/- 32 minutes. This was significantly shorter (p < 0.02) than in the patients who were admitted through A&E, in whom the average time from call for help to thrombolysis was 112 +/- 35 minutes. Twenty-one of 25 fast-tracked patients fulfilled the criteria for CCU admission. CONCLUSION: The majority of fast-trackings are appropriate and will result in quicker administration of thrombolysis in hospitals where the facility for thrombolysis does not exist in the A&E department. |
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Authors:
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S Banerjee; W E Rhoden |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Journal of the Royal College of Physicians of London Volume: 32 ISSN: 0035-8819 ISO Abbreviation: J R Coll Physicians Lond Publication Date: 1998 Jan-Feb |
Date Detail:
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Created Date: 1998-05-01 Completed Date: 1998-05-01 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 7503108 Medline TA: J R Coll Physicians Lond Country: ENGLAND |
Other Details:
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Languages: eng Pagination: 36-8 Citation Subset: IM |
Affiliation:
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Department of Cardiology, Barnsley District General Hospital. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Chest Pain
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diagnosis Coronary Care Units* Critical Care / manpower, methods* Electrocardiography Emergency Medical Technicians Emergency Service, Hospital Humans Myocardial Infarction / diagnosis*, therapy* Patient Admission* Thrombolytic Therapy |
| Comments/Corrections | |
Comment In:
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J R Coll Physicians Lond. 1998 Mar-Apr;32(2):176
[PMID:
9597638
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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