The effect of ESI ti=riage, in improving the time of fibrinolytic therapy in patients with acute ST-elevation MI

Document Type : Research Paper


1 Assistant professor of emergency medicine / School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

2 Postgraduate Student of Internal Medicine / Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran


Introduction: Acute Myocardial Infarction is one of the most common diseases all over the world and the first cause of death in Iran. Reperfusion therapy is the cornerstone of the effective treatment in these patients. Early thrombolytic therapy leads to better coronary reperfusion, and a greater reduction in mortality and reinfarction rates. The main purpose of this study, was to evaluate the effect of ESI triage, in improving the time of fibrinolytic therapy, in patients with ST-elevation MI, in emergency department of Imam Reza Hospital ( from December 2009 to june 2012).
Materials and methods: This was an observational prospective study - before and after the implementation of ESI triage- Carried out, in 210 patients with STE- MI, referred to Imam Reza Hospital Emergency department. We compared door-to-ECG and door-to-needle times, between the two groups; spot check triage and  ESI triage.
Results: Overall 210 patients were included in this study, 105 patients were triaged through spot check method  and 105 patients triaged through ESI triage. The mean age of the patients, was 55.56 ± 1.36 years The door-to-ECG time was significantly lower in the ESI triage group than spot check triage ones (35±10.38 v.s. 15.02±10.33 mins) (p<0.001). The door-to-needle time was also, significantly lower in the ESI- triaged patients (50.23±11.10 v.s. 30.56±6.03 mins) (p<0.001).
Conclusion: Implementation of ESI triage , can Significantly lower the door-to-needle time in the patients with STEMI, and hence, decrease the morbidity and mortality in these Patients.