[Delay in the administration of thrombolytics in myocardial infarct]

Abstract

Objective: To evaluate whether fast track of patients with myocardial infarction, from the emergency department to the intensive care unit, significantly decreased the intrahospital delay in the administration of anti-thrombolytic agents.

Patients and methods: Descriptive study performed in two phases (12 and 15 months, respectively) in a second-level hospital serving a community of 260,000 inhabitants (78,000 emergencies/year).

Results: A total of 264 patients with myocardial infarction participated (79.2% males); the intrahospital delay in the administration of anti-thrombolytic agents was 206.1 minutes (SD: 115.8) in 1995, versus 74.9 minutes (SD: 38.5) during 1997-1998, already with the fast track system in operation (difference of 2 hours statistically significant [p < 0.001]). Only five patients received therapy before 30 minutes.

Conclusions: Although fast track at the intensive care unit notable decreased the delay in the administration of anti-thrombolytic agents, this delay is still excessive (over half and hour). Therefore, the authors propose the administration of the thrombolytic agents at the emergency department as additional strategy to reduce the delay.