Delay before treatment
Name Just_del
Chapter MINAP/Reperfusion treatment
Definition
Delay before treatment can occuer at any time from the moment of arrival of the ambulance crew. Where it is policy for prehospital treatment to be given, any of the reasons of delay can be used by the paramedic crew. Applies to all forms of reperfusion treatment.
Data Type Categorical
Data sources MINAP
Repeated No
Valid event date range 01/01/2003 - 08/06/2009
Agreed 01/12/2010 (Revision 9.1)
Category DefinitionNotes
0 No There was no operational delay regardless of the time to treatment.
1 Sustained hypertension As defined by local protocol.
2 Clinical concern about recent cerebrovascular event or surgery Wher delay results from need to check on significance of recent cerebrovascular event or operative procedure.
3 Delay obtaining consent Where patient requests delay. Use only when the patient wishes to take time to consider treatmnet options.
4 Initial ECG ineligible Where, after an initial ineligible ECG, reperfusion teratment is used after development of ST elevation. These patients are not included in DTN and CTN analyses.
5 Cardiac arrest Cardiac arrest includes an arrest occuring before arrival in hospital.
6 Obtaining consent for therapeutic trial Consent for a therapeutical trial. Use only for an approved study.
7 Hospital administrative failure Includes any valid procedural reason why treatment was delayed in hospital.
8 Ambulance procedural delay This includes any pre- hospital delay outside the control of the ambulance service, eg incorrect address, difficulty finding address, unable to gain entry to patient's house, patient reasons eg initial refusal to go to hospital or extended domestic arrangments, adverse weather conditions, stabilising the patient, crew had to wait for boat, helicopter delay, wait for police to gain entry, failure to cannulate.
9 Other Use for any delay not coverde by other options.
10 Ambulance 12 lead ECG not diagnostic of STEMI When initial ambulance 12 lead ECG is non diagnostic of STEMI.
11 Cinsideration of primary PCI Where consideration for primary PCI led to a delay in providing thrombolysis.
12 Ambnulance administrative delay When initial ambulance 12 lead ECG is diagnostic of STEMI but patient outwith local criteria for paramedic thrombolysis.
13 Cath lab access delayed
14 Delay in activating cath lab team
15 Re - PCI complication Includes cardiogenic shock and insertion of IABP and temporary pacing.
16 Equimpment failure
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