Acute myocardial infarction : a study of door - to - needle time of thrombolytic therapy
| dc.contributor.author | Osman, Sharifudin | |
| dc.date.accessioned | 2017-08-22T00:47:55Z | |
| dc.date.available | 2017-08-22T00:47:55Z | |
| dc.date.issued | 2001-11 | |
| dc.description.abstract | The objectives of this study were firstly to show that it is possible to start thrombolytic therapy for acute myocardial infarction in the Emergency Department, Hospital Kuala Lumpur and probably in other emergency departments of other hospitals in the country. Secondly to show that the door to needle time is shorter if we were to start the thrombolytic therapy in the emergency department rather than in the coronary care unit ward. Thirdly that there would be an improvement in the door to needle time in the management of acute myocardial infarct in the emergency department once the staff of the department had more experience. The study in 1997 where all patients who were diagnosed as acute myocardial infarct were started on streptokinase except in cases during the admission days of Universiti Kebangsaan Malaysia, in which the pennission was not given. In 1997 we had 67 patients and in 1998 we did the study until July as we had gathered 66 patients. The door- to- needle time of starting thrombolytic therapy was calculated from the time of registration of the patients till the time the patient was started on streptokinase. All the names of the patients were recorded by the staff nurses in the special registration book specifically opened for these cases. All cases of acute myocardial infarction was treated and observed in the resuscitation zone in the Emergency Department Hospital Kuala Lumpur before being sent to the coronary care unit ward which is in the fourth floor of the hospital. Besides recording the door to needle time we also recorded the name, race, sex and age of the patients, We also recorded the early complications of the thrombolytic therapy in the emergency department and also when the patient is in the coronary care unit. The data was analysed using Fisher's exact test or chi-square test comparing the door to needle time in 1997 and 1998 and statistical significance was taken as p<0.05. The results of this study showed that thrombolytic therapy for acute myocardial infarct could be started in the emergency department From this study, it was found out that:- 1. The door to needle time was 38 minutes in 1997 and in 1998 it improved to 26 minutes. It was statistically significant with a p value less than 0.05. 2. Males outnumber females in the number of acute myocardial infarct. There were 122 male patients compared to 11 female patients and the percentage was 91.7% compared to 8.3%. 3. The number of patients of Indian origin with acute myocardial infarct was more compared to the Chinese. Comparing to the population of Malaysia, in which the Indians only comprised of 7% of the population, the incidence of acute myocardial infarct was relatively high compared to the Malays and the Chinese. 4. Complications did occur, the commonest was dysrthymia, followed by minor bleeding~ we saw one death immediately after starting streptokinase. No stroke was seen in cases where we started streptokinase. Based on the results of this study, the following guidelines have been proposed:- 1. It is possible to start thrombolytic therapy in acute myocardial infarction in the emergency department. 2. It is better to start thrombolytic therapy in the smaller hospitals than transferring the case to bigger hospitals before starting thrombolytic therapy. This is to shorten the symptom-to-needle time. | en_US |
| dc.identifier.uri | http://hdl.handle.net/123456789/4400 | |
| dc.language.iso | en | en_US |
| dc.publisher | Universiti Sains Malaysia | en_US |
| dc.subject | Throtnbolytic therapy | en_US |
| dc.title | Acute myocardial infarction : a study of door - to - needle time of thrombolytic therapy | en_US |
| dc.type | Thesis | en_US |
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