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ED overcrowding can be harmful to heart attack patients

Quality Improvement Monitor, November 7, 2004

Overcrowding in hospital emergency departments (EDs) can cause delays that can be deadly to heart attack patients if it hinders their ability to receive lifesaving clot-busting medications, according to a new study in the Annals of Emergency Medicine. The study was released Oct. 26.

Researchers from Toronto's Institute for Clinical Evaluative Sciences reviewed 3,452 thrombolysis patients with a mean age of 63 years. About 73% of the patients were male. They found that the overall median door-to-needle time ranged from 40 to 47 minutes, depending on whether the ED was moderate- to highly-crowded, respectively.

Door-to-needle time represents the time from when a suspected heart attack patient arrives at the ED to when the patient receives clot-busting medications. It is considered an important quality measure that's associated with whether the patient survives, says Michael D. Schull, MD, the lead author of the study, "Emergency Department Crowding and Thrombolysis Delays in Acute Myocardial Infarction."

"Our research indicates that crowding does delay door-to-needle time, and may lead to higher mortality for some heart attack patients," he says.

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