Anton,
Are you advocating that this (Cath lab staffing costs for primary PTCA) is
where limited resources should be being spent in the first instance? Should
the provison of both strategies be mutually exclusive?
Do you believe proximity (running time) to hospital should impact on whether
prehospital thrombolysis is offered/delivered?
Do you believe there is a will amoungst cardiologists both locally and
nationally to deliver primary PTCA 24/7?
John Black
-----Original Message-----
From: [log in to unmask]
[mailto:[log in to unmask]]
Sent: 15 October 2002 12:56
To: [log in to unmask]
Subject: Re: Hurry up there get a move on!!!![Scanned]
Dear Katherine,
Some good discussion about urban pre-hosp thrombolysis in EMJ, so won't
regurg that, suffice to say that there is some evid to suggest that where
hosp systems can't achieve Door to Needle in 20 minutes, we need to consider
pre-hosp thrombolysis.
I think there is a separate debate about whether we would prefer more
resources put into cath labs with 24 hours primary PTCA capability rather
than into pre-hosp thrombolysis or reducing Door to Needle times. And if we
go down the primary PTCA route, whether we should be administering a single
dose of eg. Reteplase pre-PTCA together with Gp2b/3a.
Anton
Staffs
In message <005701c273c7$76a4e780$0d210a0a@ntw852> Katherine Henderson
<[log in to unmask]> writes:
> 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
> >
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