Key result
Among 133 patients referred by general practitioners for suspected myocardial infarction, only 3% received aspirin, while 21% received intravenous opiates and 14% received intramuscular opiates.
Why the study?
Does pre-hospital administration of opiates and aspirin improve pain on arrival in patients with suspected myocardial infarction?
Cross-Sectional (n=133)
Does pre-hospital administration of opiates and aspirin improve pain on arrival in patients with suspected myocardial infarction?
The study highlights a very low rate of pre-hospital aspirin administration (3%) by general practitioners for patients with suspected myocardial infarction.
Low prehospital aspirin use by GPs in suspected MI signals a care gap; leaves open whether targeted interventions improve uptake and outcomes.
relevant details regarding the patients, use of opiate analgesia and aspirin, and presence of chest pain were recorded.Serial cardiac enzyme measurements and electrocardiograms were used to establish a final diagnosis.One hundred and thirty three of the patients (83%) were referred by general practitioners either directly to coronary care (n=91) or via the casualty department (n= 42).A total of 66 ofthem had a discharge diagnosis of myocardial infarction.The administration of opiates and aspirin to the total group and to the subgroup with infarcts is summarised in the table.Isolated rises in creatine kinase activity were observed in four out of 10 patients who did not have a myocardial infarction but who had received intramuscular analgesia.No haema- tomas were detected in the seven patients who received both intramuscular opiate and thrombolytic therapy.Patients referred on account ofsuspected myocardial infarction No (O/o) receiving No (%/6) who after treatment treatment a, b, or c were pain free on arrival Total Subtotal with with Patients Patients suspected definite with with infarcts infarcts suspected definite Treatment given (n= 133) (n-66) infarcts infarcts (a) Intravenous opiate 28 (21) 12 (18) 14 (50) 6 (50) (b) Intramuscular opiate 19 (14) 9 (14) 7 (37) 3 (33) (c) No opiate 86 (65) 45 (68) 28 (33) 11 (24) Aspirin 4 (3) 0 --
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Moher et al. (1994) conducted a cross-sectional in Suspected myocardial infarction (n=133). Prehospital administration of aspirin and opiates was evaluated on Administration of aspirin and opiates by general practitioners. Among 133 patients referred by general practitioners for suspected myocardial infarction, only 3% received aspirin, while 21% received intravenous opiates and 14% received intramuscular opiates.
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