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In South Manchester the clock starts when the ambulance stops at the ED. Most people have a triage time between 2 and 3 minutes later. Both times are recorded but the ambulance stop time to thrombolysis time is taken as the bottom line. Simon PS nobody ever checks that all the clocks are in time with each other! Simon & Fiona Carley [log in to unmask] http://www.bestbets.org ----- Original Message ----- From: "Adrian Fogarty" <[log in to unmask]> To: <[log in to unmask]> Sent: Wednesday, February 19, 2003 10:26 AM Subject: Re: Written consent for thrombolysis > ----- Original Message ----- > From: "Dunn Matthew Dr. > Subject: Re: Written consent for thrombolysis > > > My worry and question concerns mainly time: trying to achieve a 20 minute > > door to needle time (of which 5 minutes is often taken up by parking the > > ambulance, offloading and moving the patient to a bed/ trolley) doesn't > > leave you with a lot of time. > > Funny you should say that, Matt, of late I have become more concerned about > how we actually measure door-to-needle times, now we are being asked to > achieve such exacting targets. The "needle" bit is fairly easy to measure > but the "door" bit can be quite nebulous and difficult to measure, certainly > in any sort of standardised way between different units. However I recently > learned from the MINAP people, that they don't actually measure "door" time > as when the patient arrives. In fact, they measure the time the patient is > registered, which is handy, 'cause this occurs some 5 to 10 minutes after > they've come through the door! I thought this was a little devious, quite > apart from being prone to some manipulation, but they tell me that all units > are being measured this way, so any benefit should even out. Nevertheless I > agree, time is still a very precious commodity in these situations. > > AF >