A community hospital's effort to expedite treatment for patients with chest pain

The purpose of this study was to determine treatment times at a community hospital that does not receive prehospital electrocardiogram (ECG) transmission and to determine the effect of time to first hospital ECG on overall door-to-drug time.

Descriptive.

238-bed Regional Medical Center in Burlington, North Carolina.

One hundred four patients with a final diagnosis of acute myocardial infarction were included in this 16-month study.

A median door-to-ECG time of 5 minutes was within the American College of Cardiology/American Heart Association recommendation of 10 minutes. Shorter treatment times to obtain the first ECG and initiate thrombolytic therapy were associated with younger patients and those arriving by ambulance.

While efficiency in obtaining a first hospital ECG on patients with suspected acute myocardial infarctions was achieved, this did not result in low door-to-drug times. Further streamlining of protocol and the exploration of prehospital initiatives may result in a significant reduction in door-to-drug times.