Compliance with the Malaysian National critical practice guidelines on the administration of thrombolytic agents in acute st-elevation myocardial infarction

Background In developing countries such as Malaysia, the primary mode for revascularization is via thrombolytic therapy. In 2001, the 1st Edition of the Malaysian Clinical Practice Guideline advised the door-to-needle time of 60 minutes. This has been revised in the 2nd Edition (2007) to 30 minutes...

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Main Authors:	SMS, Azarisman, Ngow, Harris Abdullah, PA, Melor, Ab Rahman, Jamalludin, Ahmad, Fauzi@Fauri, Satwi, Sapari, K., Khairi, S, Noorfaizan, Maskon, Oteh
Format:	Article
Language:	English
Published:	LIPPINCOTT WILLIAMS & WILKINS 2008
Subjects:	RC Internal medicine
Online Access:	http://irep.iium.edu.my/5252/ http://irep.iium.edu.my/5252/ http://irep.iium.edu.my/5252/1/Combined_Circulation_Abstracts%5B1%5D.pdf

id	iium-5252
recordtype	eprints
spelling	iium-52522016-03-10T04:01:51Z http://irep.iium.edu.my/5252/ Compliance with the Malaysian National critical practice guidelines on the administration of thrombolytic agents in acute st-elevation myocardial infarction SMS, Azarisman Ngow, Harris Abdullah PA, Melor Ab Rahman, Jamalludin Ahmad, Fauzi@Fauri Satwi, Sapari K., Khairi S, Noorfaizan Maskon, Oteh RC Internal medicine Background In developing countries such as Malaysia, the primary mode for revascularization is via thrombolytic therapy. In 2001, the 1st Edition of the Malaysian Clinical Practice Guideline advised the door-to-needle time of 60 minutes. This has been revised in the 2nd Edition (2007) to 30 minutes. This study aims to evaluate the mean door-to-needle times following the implementation of Emergency Department-based thrombolysis. Methods Accident and Emergency-based (A�E) thrombolysis was initiated at Hospital Tengku Ampuan Afzan Kuantan, Malaysia. Ninety four patients with acute ST elevation myocardial infarction patients were screened and 75 patients were recruited. The mean house-to-door, door-to-needle times were recorded. Results The majority of patients were male (89.3%), of Malay ethnicity (84%), presenting with anterior MI (69.3%) with a mean age of 57.0 � 9.52 years. The mean door-to-needle time was 80.54 � 84.8 minutes (116.46 � 109.00 minutes before the implementation). Only 20% achieved the 30-minute door-to-needle time and only 65.3% achieved the 60 minute door-to-needle time. The reasons for late thrombolysis were quoted as late referrals from A�E (50%), hypertensive emergency (22%), resuscitation (17%) and others (11%). Conclusion Implementation of Emergency-based thrombolysis has improved the door-to-needle times but more staff education and training is required due to the high rate ofblate A�E identification and late referrals. LIPPINCOTT WILLIAMS & WILKINS 2008-05-13 Article PeerReviewed application/pdf en http://irep.iium.edu.my/5252/1/Combined_Circulation_Abstracts%5B1%5D.pdf SMS, Azarisman and Ngow, Harris Abdullah and PA, Melor and Ab Rahman, Jamalludin and Ahmad, Fauzi@Fauri and Satwi, Sapari and K., Khairi and S, Noorfaizan and Maskon, Oteh (2008) Compliance with the Malaysian National critical practice guidelines on the administration of thrombolytic agents in acute st-elevation myocardial infarction. Circulation, 118 (12). E206-E207 . ISSN 0009-7322 http://apps.webofknowledge.com/full_record.do?product=WOS&search_mode=GeneralSearch&qid=5&SID=T2ADnb8FamD8DhD@H8j&page=1&doc=1
repository_type	Digital Repository
institution_category	Local University
institution	International Islamic University Malaysia
building	IIUM Repository
collection	Online Access
language	English
topic	RC Internal medicine
spellingShingle	RC Internal medicine SMS, Azarisman Ngow, Harris Abdullah PA, Melor Ab Rahman, Jamalludin Ahmad, Fauzi@Fauri Satwi, Sapari K., Khairi S, Noorfaizan Maskon, Oteh Compliance with the Malaysian National critical practice guidelines on the administration of thrombolytic agents in acute st-elevation myocardial infarction
description	Background In developing countries such as Malaysia, the primary mode for revascularization is via thrombolytic therapy. In 2001, the 1st Edition of the Malaysian Clinical Practice Guideline advised the door-to-needle time of 60 minutes. This has been revised in the 2nd Edition (2007) to 30 minutes. This study aims to evaluate the mean door-to-needle times following the implementation of Emergency Department-based thrombolysis. Methods Accident and Emergency-based (A�E) thrombolysis was initiated at Hospital Tengku Ampuan Afzan Kuantan, Malaysia. Ninety four patients with acute ST elevation myocardial infarction patients were screened and 75 patients were recruited. The mean house-to-door, door-to-needle times were recorded. Results The majority of patients were male (89.3%), of Malay ethnicity (84%), presenting with anterior MI (69.3%) with a mean age of 57.0 � 9.52 years. The mean door-to-needle time was 80.54 � 84.8 minutes (116.46 � 109.00 minutes before the implementation). Only 20% achieved the 30-minute door-to-needle time and only 65.3% achieved the 60 minute door-to-needle time. The reasons for late thrombolysis were quoted as late referrals from A�E (50%), hypertensive emergency (22%), resuscitation (17%) and others (11%). Conclusion Implementation of Emergency-based thrombolysis has improved the door-to-needle times but more staff education and training is required due to the high rate ofblate A�E identification and late referrals.
format	Article
author	SMS, Azarisman Ngow, Harris Abdullah PA, Melor Ab Rahman, Jamalludin Ahmad, Fauzi@Fauri Satwi, Sapari K., Khairi S, Noorfaizan Maskon, Oteh
author_facet	SMS, Azarisman Ngow, Harris Abdullah PA, Melor Ab Rahman, Jamalludin Ahmad, Fauzi@Fauri Satwi, Sapari K., Khairi S, Noorfaizan Maskon, Oteh
author_sort	SMS, Azarisman
title	Compliance with the Malaysian National critical practice guidelines on the administration of thrombolytic agents in acute st-elevation myocardial infarction
title_short	Compliance with the Malaysian National critical practice guidelines on the administration of thrombolytic agents in acute st-elevation myocardial infarction
title_full	Compliance with the Malaysian National critical practice guidelines on the administration of thrombolytic agents in acute st-elevation myocardial infarction
title_fullStr	Compliance with the Malaysian National critical practice guidelines on the administration of thrombolytic agents in acute st-elevation myocardial infarction
title_full_unstemmed	Compliance with the Malaysian National critical practice guidelines on the administration of thrombolytic agents in acute st-elevation myocardial infarction
title_sort	compliance with the malaysian national critical practice guidelines on the administration of thrombolytic agents in acute st-elevation myocardial infarction
publisher	LIPPINCOTT WILLIAMS & WILKINS
publishDate	2008
url	http://irep.iium.edu.my/5252/ http://irep.iium.edu.my/5252/ http://irep.iium.edu.my/5252/1/Combined_Circulation_Abstracts%5B1%5D.pdf
first_indexed	2023-09-18T20:13:45Z
last_indexed	2023-09-18T20:13:45Z
_version_	1777407650054537216

Compliance with the Malaysian National critical practice guidelines on the administration of thrombolytic agents in acute st-elevation myocardial infarction

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