Delays in Reaching the Cardiac Care Unit: An Analysis

¹ St. Luke's Hospital
² Head, Division of Cardiology, St. Luke's Hospital; and Assistant Professor of Medicine, Case-Western Reserve University School of Medicine

Seventy-five patients were studied with regard to the occurrence of delays before entering a cardiac care unit. The greatest delay was the decision time, the interval between the onset of acute symptoms and a patient's decision to seek medical help. Second most important cause for delay was physician delay. A lengthy waiting period in the emergency room was also found. Transportation time appeared of less consequence when other delays were considered; thus the need for mobile coronary care units was questioned. The results indicate that community oriented educational programs are required to more fully inform the population at risk of symptoms of acute myocardial infarction. Earlier hospitalization of patients with chest discomfort by physicians is also needed. Furthermore, individual hospital evaluations similar to the present study, by underscoring where significant delays occur, may help expedite the care of these patients.