| Myocardial Infarction Triage and Intervention Project--phase I: patient characteristics and feasibility of prehospital initiation of thrombolytic therapy. | |
| | |
MedLine Citation:
|
PMID: 2312978 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
Prehospital initiation of thrombolytic therapy by paramedics, if both feasible and safe, could considerably reduce the time to treatment and possibly decrease the extent of myocardial necrosis in patients with acute coronary thrombosis. Preliminary to a trial of such a treatment strategy, paramedics evaluated the characteristics of 2,472 patients with chest pain of presumed cardiac origin; 677 (27%) had suitable clinical findings consistent with possible acute myocardial infarction and no apparent risk of complication for potential thrombolytic drug treatment. Electrocardiograms (ECGs) of 522 of the 677 patients were transmitted by cellular telephone to a base station physician; 107 (21%) of the tracings showed evidence of ST segment elevation. Of the total 2,472 patients, 453 developed evidence of acute myocardial infarction in the hospital; 163 (36%) of the 453 had met the strict prehospital screening history and examination criteria and 105 (23.9%) showed ST elevation on the ECG and, thus, would have been suitable candidates for prehospital thrombolytic treatment if it had been available. The average time from the onset of chest pain to prehospital diagnosis was 72 +/- 52 min (median 52); this was 73 +/- 44 min (median 62) earlier than the time when thrombolytic treatment was later started in the hospital. Paramedic selection of appropriate patients for potential prehospital initiation of thrombolytic treatment is feasible with use of a directed checklist and cellular-transmitted ECG and saves time. This strategy may reduce the extent and complications of infarction compared with results that can be achieved in a hospital setting. |
| | |
Authors:
|
W D Weaver; M S Eisenberg; J S Martin; P E Litwin; S M Shaeffer; M T Ho; P Kudenchuk; A P Hallstrom; M D Cerqueira; M K Copass |
Related Documents
:
|
19192428 - Type 2 diabetes and coronary heart disease: focus on myocardial infarction. 1909218 - Comparative effects of apsac and rt-pa on infarct size and left ventricular function in... 2448888 - Depression of tissue plasminogen activator (t-pa) activity and rise of t-pa inhibition ... 20473008 - Association between admission mean platelet volume and coronary patency after thromboly... 15140258 - Perioperative risk stratification in non cardiac surgery: role of pharmacological stres... 12388328 - Influence of gender on the response to hemodynamic overload after myocardial infarction. |
Publication Detail:
|
Type: Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S. |
Journal Detail:
|
Title: Journal of the American College of Cardiology Volume: 15 ISSN: 0735-1097 ISO Abbreviation: J. Am. Coll. Cardiol. Publication Date: 1990 Apr |
Date Detail:
|
Created Date: 1990-04-24 Completed Date: 1990-04-24 Revised Date: 2007-11-14 |
Medline Journal Info:
|
Nlm Unique ID: 8301365 Medline TA: J Am Coll Cardiol Country: UNITED STATES |
Other Details:
|
Languages: eng Pagination: 925-31 Citation Subset: AIM; IM |
Affiliation:
|
Department of Medicine, University of Washington, Seattle. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adult Aged Electrocardiography Emergency Medical Services* Feasibility Studies Humans Middle Aged Myocardial Infarction / diagnosis, drug therapy* Thrombolytic Therapy / methods* Triage* Washington |
| Grant Support | |
ID/Acronym/Agency:
|
HL 38454-01A1/HL/NHLBI NIH HHS |
| Comments/Corrections | |
Comment In:
|
J Am Coll Cardiol. 1990 Apr;15(5):937-9
[PMID:
2312979
]
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Sudden death due to isolated acute infarction of the His bundle.
Next Document: Syncope in hypertrophic cardiomyopathy: multivariate analysis of prognostic determinants.