Does a policy of direct admission to the coronary care unit reduce admission delay and increase thrombolytic treatment in patients with acute myocardial infarction?
Direct admission to the CCU bypassing the emergency department significantly reduces time to treatment and increases the proportion of acute MI patients receiving timely thrombolysis.
Because thrombolytic treatment is effective only if it is given within six hours of acute myocardial infarction it is vital to admit patients to the coronary care unit as soon as possible after the acute event. A policy of admitting patients to the coronary care unit at the request of the patient's general practitioner by a telephone line that is independent of the hospital switchboard significantly reduced the delay. Those admitted via the accident and emergency department at the same hospital reached the coronary care unit 1 h 32 min after being seen by the general practitioner whereas the patients admitted directly took only 43 minutes corrected. The policy of direct admission also significantly increased both the percentage of patients who received thrombolytic treatment and the percentage of patients admitted within three hours from the onset of symptoms.
BURNS et al. (1989) studied this question.