Katherine,
Building on your important points, from the public health perspective we
need to be investing more resources to educate the public to dial 999 early
to reduce the well documented problem of symptom to call time - this we know
is frequently several hours and profoundly impacts on both prehospital and
hospital therapeutic windows.
Best wishes - and good luck with this important work.
John Black
-----Original Message-----
From: [log in to unmask] [mailto:[log in to unmask]]
Sent: 16 October 2002 16:54
To: [log in to unmask]
Subject: Re: Hurry up there get a move on!!!![Scanned]
To be fair the 60 minute target has been in the NSF all along - this is not
a
new invention and for my two hospitals we have been very aware of it and
work
with the prehospital team - shared education.
On the pre hospital thrombolysis front I think the idea of the 60 minute
target
is so that local areas can find a system that works for them - either pre or
in
hospital thrombolysis as long as the 60 minutes is met.
I agree that primary angio is probably the way to go but I don't think
anyone
has access.
Thanks to those who have commented
KATHERINE
Quoting Richard BAILEY <[log in to unmask]>:
> I'm a bit fed up with trying to hit goalposts that are constantly moving.
> Can't we initially concentrate on achieving acceptable door to needle
times
> [be that 20 or 30 minutes] before moving on to a new, more problematic
> target that crosses pre-hospital/hospital boundreys?
>
> Best wishes, Bill
>
> ----- Original Message -----
> From: Katherine Henderson <[log in to unmask]>
> To: <[log in to unmask]>
> Sent: Monday, October 14, 2002 2:20 PM
> Subject: Re: Hurry up there get a move on!!!![Scanned]
>
>
> > Dear all,
> >
> > There is a DOH review of the 20 minute target underway. I am /will be
> > involved in it as part the CHD Collaborative National team along with
the
> > CHD Collaborative Clinical Lead, Judith Fisher with a pre hospital
slant,
> > Douglas Chamberlain as a grand old man of Cardiology, Tom Quinn as DOH
CCU
> /
> > nursing angle. The review is being led by Joe Carver who also works for
> the
> > CHD Collaborative. The feeling so far is that the 20 minute target may
> not
> > be the one to focus on and that the 60 minute call to needle is a better
> > target and nearer the time that really matters of pain to needle but is
> the
> > bit we have control of in the health system. How do people feel about
> > this????- Comments very welcome as big meeting on Friday
> >
> > Dr Katherine Henderson
> > A&E Homerton/RLH
> > ----- Original Message -----
> > From: <[log in to unmask]>
> > To: <[log in to unmask]>
> > Sent: Monday, October 14, 2002 10:39 AM
> > Subject: Re: Hurry up there get a move on!!!![Scanned]
> >
> >
> > > The inside word is that this may not go ahead and that door to needle
> > times will be kept at 30mins - there is concern that insufficient
> hospitals
> > will be able to achieve 20mins and the government will not look good
> > > FB
> > >
> > > ----------
> > > From: p=NHS NATIONAL
> > INT;a=NHS;c=GB;dda:RFC-822=ACAD-AE-MED(a)JISCMAIL.AC.UK;
> > > Sent: 14 October 2002 10:34
> > > To: p=NHS NATIONAL
> > INT;a=NHS;c=GB;dda:RFC-822=ACAD-AE-MED(a)JISCMAIL.AC.UK;
> > > Subject: Re: Hurry up there get a move on!!!![Scanned]
> > >
> > > I am really excited by this. What is the source of your info.?
> > >
> > > JP
> > >
> > > >>> Danny McGeehan 10/12/02 07:09pm >>>
> > > Door to needle times are to be reduced from 30 to 20 mins in
the
> > next 12
> > > months in spite of the fact that there is no literature to
> support
> > the
> > > clinical effectiveness of this move. The rationale being that
> if
> > it is
> > > quicker it must be better. A&E Depts showing a 100%
compliance
> > will be given
> > > Beacon status and the lead clinicians will be given 3 DP's.
> > >
> > > Units that do not acheive the golden 30 min rule will be
> > downgraded to trauma
> > > centres. However to improve the targets and to crank up the
A&E
> > staff who are
> > > not working efficiently or dare I say it hard enough there are
> now
> > plans afoot
> > > to reduce door to needle times even more and figures of 10
mins
> or
> > dare I say
> > > it 5 minutes are being quoted to make the system one of the
most
> > efficient in
> > > the world. Already clinical staff are being recruited to
> collate
> > data from
> > > overstaffed units to monitor the effectiveness of the new
> targets.
> > >
> > > Don't say you haven't been warned I heard this from a usually
> very
> > reliable
> > > source. Please keep it under your hat.
> > >
> > > Danny McGeehan
> > >
> >
>
---------------------------------------------------
This mail sent through http://www.easynetdial.co.uk
|