Door to Needle Time in Acute Myocardial Infarction Patients

Abstract

To determine the current door-to-needle time for the administration of fibrinolytics for acute myocardial infarction (AMI) in emergency room.
Methods: In this cross sectional study patients presenting with acute myocardial infarction (AMI) were included. Time interval from patient’s presentation to administration of streptokinase to the patient, was calculated . The total door-to-needle time was calculated and patient demographics and presentation, physician’s experience, clinical symptomology and reasons for delays in thrombolytic administration were analysed.
Results: Sixty six patients, presented with AMI, were given streptokinase. Out of these, 6% received streptokinase within 15 minutes of arrival in emergency, 22.7%received streptokinase in 30 minutes, 33.33% received thrombolytic agent in 45 minutes, 27.27% received thrombolytic therapy in 60 minutes, and 10.7% received thrombolytic therapy in 90 minutes. The mean door to needle time calculated was 44.8 minutes. Patients receiving reperfusion therapy within 30 minutes were 28.7%.
Conclusion: A significant number of patients were not thrombolysed within 30 minutes of presentation.The non-availability of senior doctors, difficulty in interpreting ECGs, atypical presentations and ER system delays, prolonged the door-to-needle time in this study