Compliance with the Malaysian National critical practice guidelines on the administration of thrombolytic agents in acute st-elevation myocardial infarction

SMS, Azarisman and Ngow, Harris Abdullah and PA, Melor and Ab Rahman, Jamalludin and Ahmad, Fauzi@Fauri and Satwi, Sapari and K., Khairi and S, Noorfaizan and Maskon, Oteh (2008) Compliance with the Malaysian National critical practice guidelines on the administration of thrombolytic agents in acute st-elevation myocardial infarction. Circulation, 118 (12). E206-E207 . ISSN 0009-7322

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Abstract

Background In developing countries such as Malaysia, the primary mode for revascularization is via thrombolytic therapy. In 2001, the 1st Edition of the Malaysian Clinical Practice Guideline advised the door-to-needle time of 60 minutes. This has been revised in the 2nd Edition (2007) to 30 minutes. This study aims to evaluate the mean door-to-needle times following the implementation of Emergency Department-based thrombolysis. Methods Accident and Emergency-based (A�E) thrombolysis was initiated at Hospital Tengku Ampuan Afzan Kuantan, Malaysia. Ninety four patients with acute ST elevation myocardial infarction patients were screened and 75 patients were recruited. The mean house-to-door, door-to-needle times were recorded. Results The majority of patients were male (89.3%), of Malay ethnicity (84%), presenting with anterior MI (69.3%) with a mean age of 57.0 � 9.52 years. The mean door-to-needle time was 80.54 � 84.8 minutes (116.46 � 109.00 minutes before the implementation). Only 20% achieved the 30-minute door-to-needle time and only 65.3% achieved the 60 minute door-to-needle time. The reasons for late thrombolysis were quoted as late referrals from A�E (50%), hypertensive emergency (22%), resuscitation (17%) and others (11%). Conclusion Implementation of Emergency-based thrombolysis has improved the door-to-needle times but more staff education and training is required due to the high rate ofblate A�E identification and late referrals.

Item Type:	Article (Journal)
Additional Information:	Impact factor = 15.202
Uncontrolled Keywords:	Pre-hospital, acute myocardial infarct, ST elevation, door-to-needle time.
Subjects:	R Medicine > RC Internal medicine
Kulliyyahs/Centres/Divisions/Institutes (Can select more than one option. Press CONTROL button):	Kulliyyah of Medicine > Department of Community Health & Family Medicine Kulliyyah of Medicine > Department of Internal Medicine
Depositing User:	Associate Professor Dr Harris Ngow Abdullah
Date Deposited:	15 Jul 2013 16:17
Last Modified:	10 Mar 2016 12:01
URI:	http://irep.iium.edu.my/id/eprint/5252

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