Document Detail

The use of thrombolytic therapy in patients presenting to a peripheral metropolitan emergency department with acute myocardial infarction.
MedLine Citation:
PMID:  8873938     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: While use of thrombolytic therapy in the management of acute myocardial infarction has become accepted practice in major teaching hospitals, its use in peripheral metropolitan hospitals has not been well accepted. AIM: To evaluate the use of thrombolytic therapy in the management of acute myocardial infarction in the Emergency Department (ED) of a peripheral metropolitan hospital. METHODS: A mixed prospective and retrospective observational study of 69 patients with acute myocardial infarction, who received thrombolytic therapy during a three year period, was conducted in a community based ED. RESULTS: Demographic data, door to drug interval, complications occurring during administration of thrombolytics and subsequent interhospital transfer were recorded. The mean door to drug interval in 1992 was 79.7 minutes (95% CI: 50.7 to 109.1) and by 1994 this had fallen to 25.6 minutes (95% CI: 18.9 to 32.3). Hypertension (22%) was the most common complication of therapy observed and cardiac arrest occurred in two cases (3.2%). A single episode of hypotension and vomiting were the only complications that occurred during interhospital transfer. There were no deaths during therapy or transfer. CONCLUSION: Thrombolytic therapy can be undertaken in the EDs of peripheral metropolitan hospitals in a safe and timely manner. There is little justification for routine medical escorts in the clinically stable post thrombolysis patient.
I G Jacobs; D M Fatovich
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Australian and New Zealand journal of medicine     Volume:  26     ISSN:  0004-8291     ISO Abbreviation:  Aust N Z J Med     Publication Date:  1996 Aug 
Date Detail:
Created Date:  1997-01-23     Completed Date:  1997-01-23     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  1264322     Medline TA:  Aust N Z J Med     Country:  AUSTRALIA    
Other Details:
Languages:  eng     Pagination:  539-42     Citation Subset:  IM    
School of Public Health, Curtin University of Technology, Perth, Western Australia.
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MeSH Terms
Aged, 80 and over
Drug Utilization Review*
Emergency Service, Hospital / statistics & numerical data*
Fibrinolytic Agents / therapeutic use
Hospitals, Urban
Medical Audit
Middle Aged
Myocardial Infarction / drug therapy*
Organizational Policy
Patient Transfer
Retrospective Studies
Streptokinase / therapeutic use
Thrombolytic Therapy / adverse effects,  utilization*
Time Factors
Tissue Plasminogen Activator / therapeutic use
Western Australia
Reg. No./Substance:
0/Fibrinolytic Agents; EC 3.4.-/Streptokinase; EC Plasminogen Activator
Comment In:
Aust N Z J Med. 1997 Apr;27(2):192   [PMID:  9145190 ]

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