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Emerg Med J 2004;21:162-164 doi:10.1136/emj.2002.003244
  • Original Article

Does a single bolus thrombolytic reduce door to needle time in a district general hospital?

  1. V Leah1,
  2. C Clark1,
  3. K Doyle1,
  4. T J Coats2
  1. 1Department of Emergency Medicine, Darent Valley Hospital, Dartford, Kent, UK
  2. 2Department of Accident and Emergency, St Bartholomew’s and the Royal London School of Medicine, Queen Mary’s University of London, London, UK
  1. Correspondence to:
 Vicki Leah
 Department of Emergency Medicine, Darenth Valley Hospital, Darenth Wood Road, Dartford, Kent DA2 8DA, UK; leah_vicki{at}hotmail.com
  • Accepted 18 March 2003

Abstract

Objectives: To answer the question “In patients presenting with ST elevation acute myocardial infarction (STEMI) and no contraindication to thrombolysis, does the introduction of Tenecteplase reduce door to needle times?”

Methods: Firstly, an observational study was performed to compare the time taken to prepare standard thrombolytic therapy with Tenecteplase. Secondly, door to needle times were compared before and after the introduction of Tenecteplase. The study was powered to be 80% sure of finding a change of 10% in the number of patients meeting the national service framework standard of a 30 minute door to needle time.

Results: Tenecteplase takes 10.5 minutes less time to prepare than standard treatment (p value <0.001). After the introduction of Tenecteplase the percentage of patients receiving thrombolysis in 30 minutes increased from 58% to 76% (p value <0.01)

Conclusion: Tenecteplase is quicker to prepare than standard therapy, resulting in a significant improvement in performance against the national service framework target.

Footnotes

  • Funding: Boehringer Ingelheim donated without charge the TNK used in this study.

  • Conflicts of interest: none declared.

Responses to this article

  • Minutes matter - Hours matter more!
    • David K Pedley,
    • Ronald J Cook, Shobhan Thakore
    Emerg Med J published online April 22, 2004

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