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Letter
National Service Framework fails to address the decision time
  1. G Lloyd,
  2. J Benger,
  3. P Kaye,
  4. S Haig,
  5. E Gilby
  1. Emergency Department, Bristol Royal Infirmary, Marlborough Street, Bristol BS2 8BW, UK
  1. Correspondence to:
 Dr G Lloyd; 
 gavin.lloyd{at}rdehc-tr.swest.nhs.uk

https://doi.org/10.1136/emj.20.2.208

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    The benefits of early thrombolysis in acute myocardial infarction are well known.1 In March 2000 the National Service Framework for coronary heart disease established a target of 60 minutes between the patient’s call for help and the delivery of thrombolysis.2 Emphasis is placed upon improved ambulance response and more efficient delivery of in hospital or prehospital thrombolysis, but hardly any attention is paid to the “decision time”: the minutes that elapse between symptom onset and a call for professional help.

    We routinely audit all patients thrombolysed in our inner …

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