A community hospital’s effort to expedite treatment for patients with chest pain

Objective: The purpose of this study was to determine treatment times at a community hospital that does not receive prehospital electrocardiogram (ECG) transmission and to determine the effect of time to first hospital ECG on overall door-to-drug time. Design: Descriptive. Setting: 238-bed Regional Medical Center in Burlington, North Carolina. Sample: One hundred four patients with a final diagnosis of acute myocardial infarction were included in this 16-month study. Results: A median door-to-ECG time of 5 minutes was within the American College of Cardiology/American Heart Association recommendation of 10 minutes. Shorter treatment times to obtain the first ECG and initiate thrombolytic therapy were associated with younger patients and those arriving by ambulance. Conclusions: While efficiency in obtaining a first hospital ECG on patients with suspected acute myocardial infarctions was achieved, this did not result in low door-to-drug times. Further streamlining of protocol and the exploration of prehospital initiatives may result in a significant reduction in door-to-drug times. (Heart Lung® 1999;28:402-8)