Community coronary units: strategies to promote pre-hospital thrombolysis.
Early diagnosis and the early delivery of pre-hospital thrombolysis in cases of acute myocardial infarction (AMI) have been shown to decrease mortality. Despite strong evidence of its benefits, pre-hospital thrombolysis rates are still worryingly low. The challenge is to empower community practitioners to deliver thrombolysis. In the Grampian region there is a network of community hospitals which have been equipped with both videoconferencing and remote telemetry equipment. This allows realtime consultation with the local accident and emergency department and coronary care unit. Early trials of the system show that clinical information can be viewed in realtime, with transfer of a 12-lead electrocardiogram at 60 s intervals. This will give general practitioners unprecedented access to specialist advice. Our aim is to use a combination of teaching and decision support technology to ensure that all patients with AMI have the opportunity to access timely and appropriate prehospital thrombolysis.
Pedley
D
D
Accident and Emergency Department, Aberdeen Royal Infirmary, Foresterhill, UK. dpedley@doctors.org.uk
Ferguson
J
J
Palombo
A
A
Richardson
J
J
D000208:Acute Disease; D003325:Coronary Care Units / Q000458:organization & administration*; D020000:Decision Support Systems, Clinical / Q000458:organization & administration; D004636:Emergency Service, Hospital / Q000458:organization & administration; D006764:Hospitals, Community / Q000458:organization & administration*; D006801:Humans; D009203:Myocardial Infarction / Q000628:therapy; D019114:Remote Consultation / Q000458:organization & administration*; D012606:Scotland; D015912:Thrombolytic Therapy / Q000379:methods*