Letter Addressing Use of Thrombolytic Therapy

June, 1991

Dear Visitor,

Emergency Medicine and Emergency Departments represent a significant step forward in the last 10 to 15 years. Nowhere is this more important than in the use of thrombolytic therapy for acute myocardial infarction. Efforts to reduce time within the Emergency Room have included EKG upon presentation as well as actual logging of the time from admission to therapy to give feedback on ER activity. Presently Early Cardiac Care is being practiced throughout the USA in the Nation's Emergency Rooms. However, what is not appreciated is the fact that only 20% of heart attack patients receive thrombolytic therapy and only 10% of patients receive within the first hour.

Thus if we rely just on thrombolytic therapy it reaches only a small percent of the population. Even more importantly patients with heart attacks have beginnings in 70% of them, but these symptoms are often lost in the business of the patient's schedule so that he or she does not come in until the pain is either severe or cardiac arrest has taken place. In order to correct this situation it is important for hospitals to extend themselves into the community with educational programs that serve to change behavior for early symptoms.

This cannot be accomplished unless the hospital provides a user friendly place where such symptoms can be checked out. The concept of the Chest Pain Emergency Room as an Early Cardiac Care Center has recently been promoted as a way to accomplish this in order to provide a win-win situation both for the hospital as well as for the patients. ¹

Information on how to set up a Chest Pain Emergency Room and how to put together a cardiac outreach program is available free from our institution. We have had ten years experience in developing this and getting out the bugs and we would be more than happy to provide you with our third generation attempt to deliver this most needed message.

If you have any interest in looking into this, please give my office a call or send for a free video kit on how to accomplish this.

Sincerely,

Raymond D. Bahr, M.D., F.A.C.P.
Medical Director
The Paul Dudley White Coronary Care

(1) Health Care Advisory Board, etc.

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