Robbie Coull
email: [log in to unmask] website: http://www.coull.net
DISCLAIMER AND CONFIDENTIALITY NOTICE
This document should only be read by those persons to whom it is addressed
and it is not intended to be relied upon by any person without subsequent
written confirmation of its contents. Accordingly the author disclaims all
responsibility and accepts no liability (including in negligence) for the
consequences of any person acting or refraining from acting on such
information prior to the receipt by those persons of subsequent written
confirmation. This document may contain confidential information belonging
to the sender which is protected by the physician-patient privilege.
If you have received this e-mail in error, please notify the author. Please
also destroy and delete the message from your computer. Any form of
unauthorised reproduction, dissemination, copying, disclosure, modification,
distribution and/or publication of this e-mail message is strictly
prohibited.
----------
From: Robbie Coull <[log in to unmask]>
Date: Mon, 24 Jul 2000 15:59:01 +0100
To: Gautam <[log in to unmask]>
Subject: Re: Pre-hospital ECGs
> Sounds like a smooth system. What bolus lytic do you use (rt-PA)? Do you
> leave after the 12-lead is done and before lysis is given?
Different practices use different lytics - urokinase is the most popular.
> How long is your typical response time? This is important in trying to
> apply the results to our area where most patients should be in A&E in 25
> minutes from call,
My patients are between 30 to 150 minutes from hospital with an additonal
ambulance response time of up to 90 minutes (can be longer if we have to
wait for air or lifeboat transport - can rarely be measured in days if the
weather is very bad). So call to door time can be anything from 40 minutes
to 4 hours or more.
> maybe with a 12-lead recorded en-route, and we can
> perform the above management (with more staff / equipment etc.) perhaps
> even quicker than 20 minutes.
I'm not convinced of that - I'm on the scene and active, but once you arrive
at A+E you have to wait for staff to be available - like Mark I have had to
treat seriously ill patients myself in A+E when there were no staff
available. The studies show it can be done faster when done on the scene.
> Certainly local GPs would not be willing
> or able to attend "?MI" calls like this at most times of the day. Their
> current response to such a request (from patient or ambulance staff)
> would be to rapidly get to A&E, and quite right too.
I agree with that - it would need specially trained paramedics or an
increase in the number of pre-hospital doctors.
>> 4. Are the increased costs involved justified?
> The last point may not have the same answer if transport to hospital
> times are (say) 45 minutes, as opposed to (say) 15 minutes.
True.
Robbie Coull
email: [log in to unmask] website: http://www.coull.net
DISCLAIMER AND CONFIDENTIALITY NOTICE
This document should only be read by those persons to whom it is addressed
and it is not intended to be relied upon by any person without subsequent
written confirmation of its contents. Accordingly the author disclaims all
responsibility and accepts no liability (including in negligence) for the
consequences of any person acting or refraining from acting on such
information prior to the receipt by those persons of subsequent written
confirmation. This document may contain confidential information belonging
to the sender which is protected by the physician-patient privilege.
If you have received this e-mail in error, please notify the author. Please
also destroy and delete the message from your computer. Any form of
unauthorised reproduction, dissemination, copying, disclosure, modification,
distribution and/or publication of this e-mail message is strictly
prohibited.
%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
|