While some studies found that increased mortality associated with delays were present solely within the first few hours of presentation and then plateaued, 7 14 others had suggested the reverse a risk that was initially unchanged and increased only after a few hours of delay.
It says the target – which stipulates that a predetermined proportion of patients should be admitted, discharged or transferred from emergency departments within four hours of presentation – had led to fewer deaths but now hospitals are struggling to keep beating it.
Patients underwent both stress CMR and stress SPECT imaging within 12 hours of presentation.
RESULTS: Less than half of the patients (46.3%) admitted to community hospitals were transferred to tertiary hospitals, and fewer (20%) were transferred early (within 48 hours of presentation).
Previously published data demonstrate that acute blood pressure variability within early hours of presentation to the emergency department (ED) is associated with an increased risk of death at 90 days [14].
In 22 patients with acute infarction in whom 44 observations of unique angiographic patency were noted within 6 hours of presentation, serial patency assessments simultaneous with all angiographic observations predicted coronary occlusion with 90% sensitivity and 92% specificity.
Using weekend status as an instrumental variable, we found no significant benefit to early catheterization, although we could not exclude an important risk reduction, particularly for catheterization within 12 hours of presentation.
This has proven an effective strategy: almost all pollen is removed within two to three hours of presentation.
Median volume of fluid resuscitation within the first 6 hours of presentation was 500 mLs (IQR 250 1000 mls).
Overall, only 46 (12%) of 381 patients received more than 1500 mLs of IV fluid within the first 6 hours of presentation.
About half (53%) of patients received at least some IV fluid within the first hour of presentation while 28% waited between 1 to 6 hours; 14% of patients received no fluid within the first 6 hours of presentation.
