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----- Original Message ----- From: "Dunn Matthew Dr. > Yes. I'm unconvinced of the benefits of prehospital ECG unless they can be > done while the ambulance is moving (having a fair amount of prehospital > experience myself I can vouch for the fact that it is quicker to do things > in the hospital). I'm pleased someone else sees this too! > I do feel a 20 minute door to needle time to be unreasonable > though - by the time the patient has been undressed and ECG done there is not > really enough time to properly explain what you're doing to them. It may > also encourage thrombolysis in the slightly dubious cases with less > consideration of benefits. Actually the NSF thrombolysis targets apply only to "barn-door" obvious cases. If the case is dubious, the deadlines, thankfully, no longer apply! But I take your point; even in obvious cases, it's still quite a feat getting under 20 minutes, but we occasionally manage to get as low as 10 minutes now in such straightforward cases. We're reaching the stage now where we're having to be very clear about how we measure our "door" time against our "needle" time, by synchronising timing on various bits of kit! Adrian Fogarty