Delay in thrombolytic treatment in acute myocardial infarction: the role of the accident and emergency department.

During a 6-week period, 248 patients presenting with chest pain presumed to be cardiac in origin, were recruited in a time and motion study in the Accident and Emergency Department of the Leicester Royal Infirmary. The study considered the ambulance-response and transfer times from the scene to the hospital, as well as the duration of the patients stay in the Department. While Ambulance Time from the scene of the incident to the hospital averaged 28 min, the time spent in the Accident and Emergency Department prior to admission averaged 76.5 min. This study was conducted in the light of growing concern expressed at the delay in administering thrombolytic agents to those patients with acute myocardial infarction (AMI). The authors propose possible ways of reducing such delays.