Wouldn't regard direct admission to CCU as a forward step ....
Surely the best place to recieve acute chest pain patients is ED? The expertise
of ED units and docs lies in rapid assessment, management and disposition of
emergency patients. Patients suspected of having MI prehospital frequently have
other conditions causing their problems, or may not require CCU admission /fulfil
thrombolysis criteria
I would suggest that if your local A&E unit thrombolysis times were an hour
perhaps the most appropriate line of attack was to look at their systems, rather
than handing a core part of ED capability on to another service.
Sometimes I fear for the future of Emergency Medicine!
Higgi
ED Registrar, Auckland, NZ
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