Time taken to provide thrombolytic therapy during acute myocardial infarction episodes in one Saudi Arabia Hospital

Abstract

Time delays in the treatment of acute myocardial infarction are reported as a leading cause of mortality and morbidity. Administering reperfusion therapy within the first hour after symptom onset is crucial for myocardial salvage thus preventing cell necrosis. Time constraints may start at the front door of a hospital. Time delays continue as the patient moves through the triage process into the emergency unit where the patient' history is taken, vital signs are recorded, a 12-lead electrocardiogram is conducted, a physical examination is performed and the patient is referred to a specialist. Only then will the eligibility for thrombolysis be decided and prescribed. "Door to needle time" delays were investigated by a retrospective study of 321 patients' files through a clinical audit done at one hospital in the United Arab Emirates. The most significant finding was that there were delays in 93.8% (n=314) of patients to be thrombolysed within a prescribed ideal time of 30 minutes after arrival, decreasing the opportunity to optimally salvage the myocardium. Recommendations were made to address the identified time constraints and enhance patient outcomes after experiencing myocardial infarction episodes.