The paramedic and ambulance technician crews radio ahead details of any patient with ischaemic sounding chest pain in advance of arrival in A&E, requesting that an ACPNS be “standing by” to receive the patient.
The aim of this audit is to evaluate the safety of the ACPNS service and compare performance, in terms of door to needle time for thrombolysis, with the coexisting fast track system. A standard for door to needle was set at 30 minutes, in accordance with the National Service Framework (CHD) target during the period studied.6 The “door” time is defined as the time of arrival at hospital as recorded by the paramedic crew, or time of registration in A&E for self referrals; the “needle” time is defined as the time of initiation of a thrombolytic infusion. Door to needle times for both systems of thrombolysis delivery, recorded prospectively as part of the hospital’s participation in the myocardial infarction national audit project (MINAP), were compared for the nine month period after the inception of the ACPNS service in February 2001. Patients who developed indications for thrombolysis after admission to hospital, that is had a non-diagnostic ECG at presentation to A&E, were not included in the audit. Copies of all documentation for ACPNS initiated thrombolysis were made for retrospective review by a consultant cardiologist, to determine if the decision to thrombolyse was both safe and appropriate at the time.
The paramedic and ambulance technician crews radio ahead details of any patient with ischaemic sounding chest pain in advance of arrival in A&E, requesting that an ACPNS be “standing by” to receive the patient.The aim of this audit is to evaluate the safety of the ACPNS service and compare performance, in terms of door to needle time for thrombolysis, with the coexisting fast track system. A standard for door to needle was set at 30 minutes, in accordance with the National Service Framework (CHD) target during the period studied.6 The “door” time is defined as the time of arrival at hospital as recorded by the paramedic crew, or time of registration in A&E for self referrals; the “needle” time is defined as the time of initiation of a thrombolytic infusion. Door to needle times for both systems of thrombolysis delivery, recorded prospectively as part of the hospital’s participation in the myocardial infarction national audit project (MINAP), were compared for the nine month period after the inception of the ACPNS service in February 2001. Patients who developed indications for thrombolysis after admission to hospital, that is had a non-diagnostic ECG at presentation to A&E, were not included in the audit. Copies of all documentation for ACPNS initiated thrombolysis were made for retrospective review by a consultant cardiologist, to determine if the decision to thrombolyse was both safe and appropriate at the time.
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