Document Detail


Impact of emergency medicine faculty on door to thrombolytic time.
MedLine Citation:
PMID:  15028324     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The objective of this study was to determine the impact of Emergency Medicine (EM) faculty presence on timely thrombolytic therapy for acute myocardial infarction in the Emergency Department (ED). We performed a retrospective study of data regarding acute myocardial infarction patients in the ED of a large urban teaching hospital. Data were collected from January 1, 1998 to December 31, 1999 when EM faculty were not present in the ED and from January 1, 2001 to December 31, 2002 when they were. We compared median time from patient arrival to thrombolytics, percent of patients receiving thrombolytics within 30 min of arrival, and percent of patients with indications for primary revascularization who received it before and after EM faculty presence. The results indicate that EM faculty presence resulted in a decrease in median time from arrival to thrombolytic administration of 17 min (95% CI: 9, 28). Before EM faculty presence, the median time was 44 min as compared to 24 min post-EM faculty presence. Patients received thrombolytic therapy within 30 min 25.8% of the time before EM faculty presence as compared to 65.4% with EM faculty presence; an absolute increase of 39.6% (95% CI: 23.0%, 56.3%). Primary revascularization occurred in 56.9% of eligible patients pre-EM faculty presence and 81.4% post-EM faculty presence; an increase of 24.5% (95% CI: 13.6%, 35.4%). We conclude that the introduction of Emergency Medicine faculty significantly improved the quality of care for acute myocardial infarction patients in a large urban Emergency Department.
Authors:
Christopher S Weaver; Sara J Avery; Edward J Brizendine; Roland B McGrath
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Publication Detail:
Type:  Comparative Study; Evaluation Studies; Journal Article    
Journal Detail:
Title:  The Journal of emergency medicine     Volume:  26     ISSN:  0736-4679     ISO Abbreviation:  J Emerg Med     Publication Date:  2004 Apr 
Date Detail:
Created Date:  2004-03-18     Completed Date:  2004-08-05     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8412174     Medline TA:  J Emerg Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  279-83     Citation Subset:  IM    
Affiliation:
Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Emergency Medicine / education*
Emergency Service, Hospital / organization & administration*,  statistics & numerical data*
Faculty / statistics & numerical data*
Female
Hospital Mortality
Humans
Indiana
Male
Middle Aged
Myocardial Infarction / mortality,  therapy*
Myocardial Reperfusion / statistics & numerical data
Outcome and Process Assessment (Health Care)
Retrospective Studies
Thrombolytic Therapy / statistics & numerical data*
Time Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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