Emergency department thrombolysis critical pathway reduces door‐to‐drug times in acute myocardial infarction

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Abstract
Background: Rapid time to treatment with thrombolytic therapy is an important determinant of survival in acute myocardial infarction (AMI). Hypothesis: We hypothesized that establishment of an AMI thrombolysis critical pathway in the Emergency Department could successfully reduce the “door‐to‐drug” time, the time between patient arrival and start of thrombolysis. Methods and results: Before establishment of the AMI critical pathway, median door‐to‐drug time was 73 min, which was reduced to 37 min after critical pathway implementation (pConclusions: Our critical pathway was successful in reducing door‐to‐drug times. We observed a “gender gap” in door‐to‐drug times, with longer mean times for women, which was reduced by the AMI critical pathway. Thus, our data provide support for the use of critical pathways to reduce door‐to‐drug times, as recommended by the National Heart Attack Alert Program.