| Wide variation in the use of thrombolytic therapy among junior doctors in south and central Scotland. | |
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MedLine Citation:
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PMID: 8655300 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: (a) To assess the practice of junior doctors who administer thrombolytic therapy in acute myocardial infarction. (b) To assess whether wider implementation of current guidelines is indicated. DESIGN: Postal questionnaire survey. Each questionnaire was followed by a reminder. SETTING: Teaching and district general hospitals in Central and Southern Scotland. SUBJECTS: Two hundred and twelve junior doctors (excluding JHO's) regularly involved in the early assessment and management of patients with acute myocardial infarction. RESULTS: One hundred and ten questionnaires were returned (response rate 52%). There was wide inter-individual variation in clinical practice regardless of whether subjects worked in teaching or district general hospitals or as cardiologists or non-cardiologists. As many as 12% of respondents administer thrombolytic therapy in the absence of ST elevation or bundle branch block on the presenting ECG. A high percentage of subjects considered diabetic retinopathy, but not a previous history of cerebrovascular disease, a contraindication to thrombolytic therapy. Only 29% and 32% respectively worked in institutions where formal policies existed for streptokinase readministration and rt-PA administration in preference to streptokinase. The administration of thrombolytic therapy in Accident and Emergency departments is not a popular strategy, and the full efficacy of rt-PA is not realised due to inappropriate use or failure to use intravenous heparin. CONCLUSIONS: There is wide variation in clinical practice among junior doctors who administer thrombolytic therapy for acute myocardial infarction. Wider implementation and firmer current national guidelines would ensure that patients presenting with suspected acute myocardial infarction receive optimal therapy. |
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Authors:
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S Hood; D Birnie; J L Curzio; W S Hillis |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Health bulletin Volume: 54 ISSN: 0374-8014 ISO Abbreviation: Health Bull (Edinb) Publication Date: 1996 Mar |
Date Detail:
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Created Date: 1996-07-26 Completed Date: 1996-07-26 Revised Date: 2009-11-11 |
Medline Journal Info:
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Nlm Unique ID: 0012330 Medline TA: Health Bull (Edinb) Country: SCOTLAND |
Other Details:
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Languages: eng Pagination: 131-9 Citation Subset: IM |
Affiliation:
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Department of Medicine and Therapeutics, University of Glasgow, Gardiner Institute, Western Infirmary, Glasgow. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Humans Medical Staff, Hospital / statistics & numerical data* Myocardial Infarction / drug therapy* Patient Selection Physician's Practice Patterns / statistics & numerical data* Practice Guidelines as Topic Questionnaires Scotland Thrombolytic Therapy / contraindications, methods, utilization* Time Factors |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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