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Community thrombolysis in the Coromandel region. Audit of the "Cardiac Events in the Coromandel-Assessment Strategy

C Nunn1, J Lennane, G Marriott

  • 1Department of Cardiology, Waikato Hospital, Hamilton.

The New Zealand Medical Journal
|June 26, 2001
PubMed

Insights

Community thrombolysis significantly reduced treatment times for acute myocardial infarction (MI) patients in New Zealand. This pilot program proved logistically feasible, improving patient outcomes by enabling faster access to critical care.

Area of Science:

  • Cardiology
  • Emergency Medicine
  • Health Services Research

Background:

  • Acute myocardial infarction (MI) requires rapid intervention to minimize cardiac damage.
  • Geographic remoteness can delay access to time-sensitive treatments like thrombolysis.
  • A pilot program was initiated in the Coromandel region to address treatment delays.

Purpose of the Study:

  • To audit the feasibility and impact of a community thrombolysis pilot program.
  • To evaluate the time efficiency of pre-hospital thrombolysis compared to in-hospital treatment.

Main Methods:

  • Nineteen patients in the Coromandel region received community thrombolysis (Retelapse) between July 1998 and December 1999.
  • ECGs were digitally transmitted for remote review by a cardiology registrar.
  • Treatment times and patient demographics were prospectively recorded; outcomes were reviewed via chart analysis. A historical cohort receiving in-hospital thrombolysis was used for comparison.

Main Results:

  • Community thrombolysis was administered to 19 patients, with no adverse events during transport or hospital stay.
  • Median time from pain onset to thrombolysis was 135 minutes, a 135-minute reduction compared to the historical cohort (median 270 minutes).
  • This time reduction was statistically significant (p=0.0003).

Conclusions:

  • Community thrombolysis is logistically feasible in the New Zealand context.
  • This approach significantly reduces treatment delays for acute myocardial infarction (MI) patients.
  • The findings support the expansion of community-based thrombolysis programs.
Abstract

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