A community hospital's effort to expedite treatment for patients with chest pain

Heart Lung. 1999 Nov-Dec;28(6):402-8. doi: 10.1016/s0147-9563(99)70029-4.

Abstract

Objective: 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: Descriptive.

Setting: 238-bed Regional Medical Center in Burlington, North Carolina.

Sample: One hundred four patients with a final diagnosis of acute myocardial infarction were included in this 16-month study.

Results: A median door-to-ECG time of 5 minutes was within the American College of Cardiology/American Heart Association recommendation of 10 minutes. Shorter treatment times to obtain the first ECG and initiate thrombolytic therapy were associated with younger patients and those arriving by ambulance.

Conclusions: While efficiency in obtaining a first hospital ECG on patients with suspected acute myocardial infarctions was achieved, this did not result in low door-to-drug times. Further streamlining of protocol and the exploration of prehospital initiatives may result in a significant reduction in door-to-drug times.

MeSH terms

  • Chest Pain / diagnosis
  • Chest Pain / therapy*
  • Electrocardiography*
  • Emergency Service, Hospital / organization & administration
  • Emergency Service, Hospital / standards*
  • Female
  • Hospitals, Community
  • Humans
  • Male
  • Middle Aged
  • Myocardial Infarction / diagnosis
  • Myocardial Infarction / therapy*
  • Thrombolytic Therapy*
  • Time Factors