Thrombolysis Nurses: Time for Review

Thrombolysis remains the most popular means of reperfusion following an acute ST-elevation myocardial infarction in the United Kingdom today. There is a wealth of evidence to support the early provision of thrombolysis care and a number of models of care delivery have been proposed to reduce the time delay from admission to hospital to administration of thrombolytic therapy. The movement of this treatment from the coronary care unit to the emergency department in association with the employment of specialist cardiac nurses has been associated with some time reductions. However the quality of evidence to support the employment of specialist cardiac nurses working outside the coronary care unit is limited. The author provides an overview of the main literature in this area outlining the models of care in operation and argues that there are lessons to be learned for future nursing research.

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The Reduction of Cardiac Patients in the Coronary Care Unit of the Santa Izabel Hospital During the COVID-19 Pandemic

Revista Científica Hospital Santa Izabel ◽

10.35753/rchsi.v4i3-4.180 ◽

2021 ◽

Vol 4 (3/4) ◽

pp. 131-134

Author(s):

Gilson Feitosa ◽

Leandro Cavalcanti ◽

Amanda Fraga ◽

Milana Prado ◽

Gilson Feitosa Filho ◽

...

Keyword(s):

Myocardial Infarction ◽

Acute Coronary Syndrome ◽

Angina Pectoris ◽

Coronary Care Unit ◽

Myocardial Revascularization ◽

St Elevation Myocardial Infarction ◽

Coronary Syndrome ◽

The World ◽

St Elevation ◽

Coronary Care

The coronary care unit by Santa Izabel Hospital (Salvador, Bahia, Brazil) made a comparison of admitted patients with coronary disease cases admitted between two equivalent periods ranging from April through July in 2019 and 2020. There was a striking reduction in 2020 of cases of ST-elevation myocardial infarction (39%); non-ST elevation myocardial infarction (19%); and unstable angina pectoris (21%). This occurred in parallel with what happened in many parts of the world and hampered offering the best treatment strategy to these patients with an acute coronary syndrome such as invasive stratification and myocardial revascularization.

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Lower mortality after prehospital recognition and treatment followed by fast tracking to coronary care compared with admittance via emergency department in patients with ST-elevation myocardial infarction

International Journal of Cardiology ◽

10.1016/j.ijcard.2007.09.001 ◽

2008 ◽

Vol 129 (3) ◽

pp. 325-332 ◽

Cited By ~ 39

Author(s):

Angela Bång ◽

Lars Grip ◽

Johan Herlitz ◽

Stefan Kihlgren ◽

Thomas Karlsson ◽

...

Keyword(s):

Myocardial Infarction ◽

Emergency Department ◽

St Elevation Myocardial Infarction ◽

Lower Mortality ◽

Fast Tracking ◽

St Elevation ◽

Coronary Care

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Reduction in Door-to-Needle Time after Transfer of Thrombolysis Site from CCU to Emergency Department

Emergency Medicine International ◽

10.1155/2013/208271 ◽

2013 ◽

Vol 2013 ◽

pp. 1-5 ◽

Cited By ~ 1

Author(s):

Osama Mohammed ◽

Firjith C. Paramba ◽

Naushad V. Aboobaker ◽

Riyadh A. Mohammed ◽

Nishan K. Purayil ◽

...

Keyword(s):

Emergency Department ◽

Coronary Care Unit ◽

Coronary Intervention ◽

Coronary Perfusion ◽

Acute Stemi ◽

Percutaneous Coronary ◽

Duration Of Hospitalization ◽

St Elevation ◽

Coronary Care ◽

Early Restoration

Objective. Early restoration of coronary perfusion by thrombolysis or percutaneous coronary intervention is the main modality of treatment to salvage the ischemic myocardium. The earlier the procedure is completed, the greater the benefit is in saving myocardium and restoring its functions. The aim of the study is to compare the door-to-needle time (DNT) in acute ST elevation myocardial infarction (STEMI) in the period prior to December 2008 when the site of thrombolysis was in coronary care unit (CCU) and the period after that when the site was shifted to emergency department (ED).Methods. A retrospective, descriptive study was conducted at Al Khor Hospital, Qatar, in patients with acute STEMI who underwent thrombolysis at CCU and ED from April 2005 until December 2011, to compare the DNT, duration of hospitalization, and mortality.Results. A total of 211 patients with acute STEMI were eligible for thrombolysis; 58 patients were thrombolysed in the CCU and 153 in ED. The median DNT was reduced from 33.5 minutes in the CCU to 17 minutes in the ED representing a reduction of more than 50% with aPvalue of < 0.0001.Conclusion. The transfer of the thrombolysis site from CCU to the ED was associated with a dramatic and significant reduction in median door-to-needle time by more than half.

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