title: Action by physicians and other health-care professionals in hospital emergency departments.
abstract: Advances in the management of acute myocardial infarction can significantly improve outcome, primarily through highly time-dependent coronary reperfusion and successfully resolving early complications. Effectiveness of treatment is now more limited by delays in reperfusion and number of patients who receive coronary reperfusion than available therapy. Specific methods of decreasing the time to reperfusion and increasing the number of patients treated must be broadly applied to further reduce morbidity and mortality. Facilities that manage myocardial infarction should be classified according to capabilities to promote emergency transport to the nearest facility offering definitive care, generally, thrombolysis or urgent PTCA. Standardized evaluation and treatment protocols are critical in providing rapid and optimum care. Essential protocols include questionnaires for thrombolysis candidacy and diagnosis triage; critical initial management pathways; patient management algorithms; and standardized orders for thrombolysis, anticoagulation, and initial coronary care admission.
authors.affiliation: American College of Cardiology, Pensacola, USA.
authors.forename: W D
authors.initials: WD
authors.lastname: Doty
authors.forename: C R
authors.initials: CR
authors.lastname: Curry
authors.forename: W
authors.initials: W
authors.lastname: Goellner
authors.forename: K I
authors.initials: KI
authors.lastname: Holman
authors.forename: H
authors.initials: H
authors.lastname: Rodenburg
authors.forename: E W
authors.initials: EW
authors.lastname: Rogers
authors.forename: F
authors.initials: F
authors.lastname: Wasserman
mesh_terms: D000465:Algorithms; D015906:Angioplasty, Balloon, Coronary; D002985:Clinical Protocols; D004636:Emergency Service, Hospital; D006282:Health Personnel; D006801:Humans; D009203:Myocardial Infarction / Q000628:therapy*; D010347:Patient Care Planning; D010820:Physicians; D015912:Thrombolytic Therapy; D016896:Treatment Outcome