Background: The use of thrombolysis in patients with acute myocardial infarction reduces mortality and morbidity. Rapid treatment after the onset of symptoms increases the benefit gained from thrombolysis.
Material and methods: The time delay in the administration of thrombolysis to 138 acute myocardial infarction patients in the hospital in Arendal, Norway was established with a retrospective chart review from January 1995 to December 1996. The results were published locally with a special focus on the time delay. To assess the effect of increased focus, a prospective registration of time delay was performed from November 1998 to December 2003. In this period, 356 acute myocardial infarctions were recorded. Second, the effect of changing the site of administering thrombolytic therapy from the coronary care unit to the emergency department was evaluated from January 2002 to December 2003.
Results: The time delay in administration of thrombolysis was reduced from a median delay of 54 minutes in the first period to a median delay of 27 minutes in the second period. No differences were found in time delay between the coronary care unit and the emergency department.
Interpretation: The time taken to administer thrombolysis to patients admitted with acute myocardial infarctions can be reduced by focusing on the delay. Changing site of treatment did not affect time delay.