2.50
Hdl Handle:
http://hdl.handle.net/10755/162617
Type:
Presentation
Title:
Acute Myocardial Infarction Management at a Community Hospital
Abstract:
Acute Myocardial Infarction Management at a Community Hospital
Conference Sponsor:Emergency Nurses Association
Conference Year:1999
Author:Leslie, , Davis
Contact Address:UNC-CH School of Nursing, Carrington Hall, CB#7460, Chapel Hill, NC, 27599
Contact Telephone:USA
Co-Authors:Holly Griffin, Galen Wagner
Purpose: With recent publications of large scale thrombolytic trials, the importance of rapidly diagnosing and treating acute myocardial infarction (AMI) patients has become a major concern for many hospital emergency departments (ED). The purpose of this study was to determine treatment times at a community hospital that does not receive prehospital electrocardiogram (ECG) transmission, and to determine the effect of time to first hospital ECG on overall door to drug time.

Design and Setting: A retrospective chart review at a 238 bed community hospital in a southern state was used to assess AMI management.

Sample: All patients with diagnosed AMIs who received intravenous thrombolytic therapy over a 16 month period were included. Two patients were excluded due to prehospital ECGs and six due to missing or incomplete data. The remaining 104 patients were primarily male (72%) and Caucasian (88%) with a mean age of 63 years.

Methodology: Hospital arrival time, first ECG time, and time of initiation of thrombolytic therapy were collected for each of the study patients through the use of the second phase of the National Registry of Myocardial Infarction (NRMI-2) data forms. Only patients whose first ECG was considered diagnostic were included in the calculation of overall door to drug time. Distributions of door to ECG and door to drug times for patients according to mode of transportation to the emergency department, gender, age, and race were examined. Medians with 25th and 75th percentiles were calculated for continuous baseline variables. The nonparametric Wilcoxon rank test was used to examine differences in the continuous variables.

Results: The median door to ECG time and door to drug times were 5 minutes and 33 minutes respectively. Longer door to ECG times were associated with older patients (p=0.0019) as were longer door to drug times for this subset of patients (p=0.0031). Although not statistically significant, there was a trend towards longer overall door to drug times for females in regard to gender differences (p=0.0697).

Conclusions: The study ED achieved rapid door to ECG times well below the American College of Cardiology/American Heart Association recommendation of 10 minutes. However, the overall median door to drug time was 3 minutes above the ACC/AHA recommendation of 30 minutes. Further streamlining of ED protocols may result in a greater number of AMI patients achieving the ACC/AHA recommendations for overall door to drug times. [Research Paper Presentation]
Repository Posting Date:
27-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Emergency Nurses Association

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleAcute Myocardial Infarction Management at a Community Hospitalen_GB
dc.identifier.urihttp://hdl.handle.net/10755/162617-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Acute Myocardial Infarction Management at a Community Hospital</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Emergency Nurses Association</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">1999</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Leslie, , Davis</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">UNC-CH School of Nursing, Carrington Hall, CB#7460, Chapel Hill, NC, 27599</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">USA</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Holly Griffin, Galen Wagner</td></tr><tr><td colspan="2" class="item-abstract">Purpose: With recent publications of large scale thrombolytic trials, the importance of rapidly diagnosing and treating acute myocardial infarction (AMI) patients has become a major concern for many hospital emergency departments (ED). The purpose of this study was to determine treatment times at a community hospital that does not receive prehospital electrocardiogram (ECG) transmission, and to determine the effect of time to first hospital ECG on overall door to drug time.<br/><br/>Design and Setting: A retrospective chart review at a 238 bed community hospital in a southern state was used to assess AMI management.<br/><br/>Sample: All patients with diagnosed AMIs who received intravenous thrombolytic therapy over a 16 month period were included. Two patients were excluded due to prehospital ECGs and six due to missing or incomplete data. The remaining 104 patients were primarily male (72%) and Caucasian (88%) with a mean age of 63 years.<br/><br/>Methodology: Hospital arrival time, first ECG time, and time of initiation of thrombolytic therapy were collected for each of the study patients through the use of the second phase of the National Registry of Myocardial Infarction (NRMI-2) data forms. Only patients whose first ECG was considered diagnostic were included in the calculation of overall door to drug time. Distributions of door to ECG and door to drug times for patients according to mode of transportation to the emergency department, gender, age, and race were examined. Medians with 25th and 75th percentiles were calculated for continuous baseline variables. The nonparametric Wilcoxon rank test was used to examine differences in the continuous variables.<br/><br/>Results: The median door to ECG time and door to drug times were 5 minutes and 33 minutes respectively. Longer door to ECG times were associated with older patients (p=0.0019) as were longer door to drug times for this subset of patients (p=0.0031). Although not statistically significant, there was a trend towards longer overall door to drug times for females in regard to gender differences (p=0.0697).<br/><br/>Conclusions: The study ED achieved rapid door to ECG times well below the American College of Cardiology/American Heart Association recommendation of 10 minutes. However, the overall median door to drug time was 3 minutes above the ACC/AHA recommendation of 30 minutes. Further streamlining of ED protocols may result in a greater number of AMI patients achieving the ACC/AHA recommendations for overall door to drug times. [Research Paper Presentation]</td></tr></table>en_GB
dc.date.available2011-10-27T10:31:13Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:31:13Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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