Asif Ullah, Mahmood-ul Hassan, Sher Bahadar Khan.
Average time for presentation to the emergency and treatment with streptokinase in patients presenting to cardiac services in local DHQ.
Pak Heart J Jan ;51(3):234-7.

Objective: To determine the door to needle time for acute ST Elevation MI patients at Kohat. Methodology: It was a cross-sectional study carried out at Cardiology department of KMU institute of medical sciences District Head Quarter Tehsil Hospital KDA Kohat. Patients with ST elevation MI were included in the study.Door to needle time was established for all. Results: Total of 100 patients were included in the study. Door to needle time was 30+-5 minutes. Mean distance from facility was 34 Kilometers; however chest pain to ER time was highly variable with minimum 177 minutes for AWMI to 480 minutes for inferolateral STEMI. Female patients encountered a delay of 239 minutes versus 172 minutes delay in males presenting to emergency care unit.Out of total 10 deaths 9 occurred in those patients who came to emergency after 45 minutes of onset of chest pain. Conclusion: There is a high variability in time of presentation to emergency unit from onset of chest pain; however door to needle time is well within 30 minutes of patient arrival. Time from onset of chest pain to presentation in the emergency room was more for the female patients.

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