PMID- 15221046
OWN - NLM
STAT- MEDLINE
DCOM- 20040928
LR  - 20061115
IS  - 0037-5675 (Print)
IS  - 0037-5675 (Linking)
VI  - 45
IP  - 7
DP  - 2004 Jul
TI  - Emergency physician versus cardiologist-initiated thrombolysis for acute 
      myocardial infarction: a Singapore experience.
PG  - 313-7
AB  - INTRODUCTION: To compare the door-to-needle time between thrombolysis 
      administration for patients with ST elevation myocardial infarction (STEMI) in 
      the emergency department (EMD) by emergency physicians and those administered in 
      the coronary care unit (CCU) by cardiologists. METHODS: The data was collected 
      prospectively for all patients with STEMI who received thrombolysis in the 
      emergency department over a one-year period from January 2001 to December 2001. 
      We recorded the time of arrival in the EMD as well as the time thrombolytic 
      therapy was commenced. This data was compared to those from the previous year, 
      obtained retrospectively, where the patients received thrombolysis in the CCU. 
      RESULTS: 118 patients were thrombolysed in the CCU and 78 patients were 
      thrombolysed in the EMD. The median door-to-needle time was significantly shorter 
      in patients who are thrombolysed in the emergency department by emergency 
      physicians than in the coronary care unit by cardiologists (29 minutes versus 60 
      minutes, p value is less than 0.001). There was no incident of inappropriate 
      thrombolysis nor was there intracranial or gastrointestinal bleed in the patients 
      who were thrombolysed in the EMD. There was one case of medication dose error but 
      it was of no consequence to the patient. CONCLUSION: Emergency physicians can 
      administer thrombolytic treatment appropriately, quickly and safely in patients 
      with STEMI.
FAU - Irwani, I
AU  - Irwani I
AD  - Emergency Department, National University Hospital, 5 Lower Kent Ridge Road, 
      Singapore 119074. irwani@nuh.com.sg
FAU - Seet, C M
AU  - Seet CM
FAU - Manning, P G
AU  - Manning PG
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - India
TA  - Singapore Med J
JT  - Singapore medical journal
JID - 0404516
RN  - 0 (Fibrinolytic Agents)
RN  - EC 3.4.- (Streptokinase)
RN  - EC 3.4.21.68 (Tissue Plasminogen Activator)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Coronary Care Units/*statistics & numerical data
MH  - Electrocardiography
MH  - Emergency Service, Hospital/*statistics & numerical data
MH  - Female
MH  - Fibrinolytic Agents/*administration & dosage/adverse effects
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/diagnosis/*drug therapy
MH  - Physicians
MH  - Prospective Studies
MH  - Retrospective Studies
MH  - Singapore/epidemiology
MH  - Streptokinase/administration & dosage/adverse effects
MH  - Thrombolytic Therapy/adverse effects/*statistics & numerical data
MH  - Time Factors
MH  - Tissue Plasminogen Activator/administration & dosage/adverse effects
EDAT- 2004/06/29 05:00
MHDA- 2004/09/29 05:00
CRDT- 2004/06/29 05:00
PHST- 2004/06/29 05:00 [pubmed]
PHST- 2004/09/29 05:00 [medline]
PHST- 2004/06/29 05:00 [entrez]
PST - ppublish
SO  - Singapore Med J. 2004 Jul;45(7):313-7.