Improvement in decision-making for thrombolysis following introduction of angioplasty referral guidelines.
OBJECTIVE
To determine whether the introduction of acute angioplasty referral guidelines would lead to an improvement in decision-making times with respect to thrombolysis for patients with acute myocardial infarction.


METHODS
Retrospective and prospective collection of 'time from diagnostic electrocardiogram to treatment' for all patients who received thrombolytic treatment for acute myocardial infarction in the emergency department.


RESULTS
Median time from 'diagnostic electrocardiogram to thrombolysis' fell from 38 to 26 min (P < 0.0001) following introduction of acute angioplasty referral guidelines. This was primarily due to an improvement in median decision-making times for patients with anterior infarcts from 65 to 27 min (P = 0.0009).


CONCLUSIONS
Significant improvements were seen in thrombolysis decision-making times for patients with acute myocardial infarction following the introduction of acute angioplasty referral guidelines.
Dilley
S
S
Department of Emergency Medicine, St Vincent's Hospital, Melbourne, Victoria, Australia. DILLEYS@svhm.org.au
D015906:Angioplasty, Balloon, Coronary; D003657:Decision Making; D004636:Emergency Service, Hospital; D017408:Guidelines as Topic; D006801:Humans; D009203:Myocardial Infarction / Q000188:drug therapy*; D011446:Prospective Studies; D012017:Referral and Consultation; D012189:Retrospective Studies; D015912:Thrombolytic Therapy; D013997:Time Factors