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Minimizing patient and system delays is essential to optimize AMI survival; extends prior RCT evidence on the 4–6 hour treatment window.
Numerous randomised trials have shown that thrombolytic treatment reduces mortality from acute myocardial infarction irrespective of the patient's age, sex, blood pressure, and previous history of myocardial infarction or diabetes.1 Maximum benefit, however, is seen in those patients treated within 4–6 hours of their symptoms starting. Patients do not always seek medical help soon enough, and this accounts for much of the delay in receiving thrombolytic treatment, but important delays also occur in hospital. These are not related to the route by which the patient is admitted to hospital and vary widely between hospitals.2 Although accident and emergency departments are in an important position to minimise any delay in giving thrombolytic treatment, a recent questionnaire study of junior hospital doctors in Scotland showed that thrombolysis is rarely given in accident and emergency departments there.3 We surveyed consultants in accident and emergency departments …
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Hood et al. (1998) studied this question.
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