Thrombolysis in Acute ST Elevation Myocardial Infarction: Determination of Door to Needle Time in a Tertiary Medical Centre
- Author:
NIK AZLAN NM
1
Author Information
1. Department of Emergency Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur, Malaysia
- Collective Name:NIK AZLAN NM; MUHAMMAD YUSRI Y
- Publication Type:Journal Article
- Keywords:
electrocardiogram;
door to needle time;
ST elevation myocardial infarction
- From:Medicine and Health
2019;14(1):44-52
- CountryMalaysia
- Language:English
-
Abstract:
Door to needle (DTN) time for thrombolysis in the Emergency Department,
Universiti Kebangsaan Malaysia Medical Centre (ED, UKMMC) is an indicator
that can reduce mortality and morbidity of patients with ST Elevation Myocardial
Infarction (STEMI). This study was conducted to determine factors that influence
DTN time for acute ST Elevation Myocardial Infarction (STEMI) and whether it
has achieved the recommended time of 30 minutes. A cross-sectional study was
conducted among patients diagnosed with acute STEMI and thrombolysed in ED,
UKMMC from June 2016 until March 2017. A data collection sheet was used to
collect patient’s demographic data and clinical data which included time of arrival
to ED, time of initial electrocardiogram (ECG), time of drug preparation and time
of thrombolytic delivery to the patient. A total of 98 patients were included in
this study. Majority of patients (77.6%) were thrombolysed more than 30 minutes
following ED arrival. Mean DTN in ED, UKKMC was 59.28 + 36.01 minutes. The
mean door to ECG time was 7.19 + 8.08 minutes and the mean drug preparation
time was 9.86 + 7.51 minutes. Out of 76 (77.6%) patients that were thrombolysed
after 30 minutes of ED arrival, 59.2% (n=45) were due to multiple disciplinary
referral. Other factors were delay in performing initial ECG 19.8% (n=15), incorrect
initial ECG interpretation 9.2% (n=7) and unavoidable need for prior resuscitation
9.2% (n=7). As a conclusion this study showed that there was an unacceptable
delay in hospital thrombolysis for acute STEMI.
- Full text:12.2019my0130.pdf
