| Paramedic-led prehospital thrombolysis is safe and effective: the East Anglian experience. | |
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MedLine Citation:
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PMID: 19465626 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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INTRODUCTION: Prehospital thrombolysis has been shown to improve patient outcomes in clinical trials and this has been confirmed in the ongoing large national myocardial infarction registry (Myocardial Infarction National Audit Project; MINAP) reports. This paper describes a system to improve the delivery of prehospital thrombolysis and the associated governance requirements to gain maximum patient benefit. METHODS: Demographic data were prospectively collected on all patients treated by the East Anglian Ambulance Trust with bolus thrombolytics for a presumed diagnosis of ST elevation myocardial infarction between November 2003 and February 2007. Survival status was determined from the NHS strategic tracing service. RESULTS: 1062 patients (mean age 64.0 years (SD 10.6), 795 men) were treated in this time period. There were 71 deaths in this group, with actuarial survival of 93.9% (SE 0.9%) at 30 days, 91.7% (SE 1.0%) at 6 months and 90.8% (SE 1.1%) at 12 months after treatment. Age and cardiac arrest were most strongly associated with mortality (both p<0.001). Twelve (1.2%) patients received thrombolysis that on review was considered inappropriate. There were no deaths in this subgroup. CONCLUSIONS: Prehospital thrombolysis can be administered safely by ambulance staff supported by a Trust clinical support system with excellent clinical outcomes. |
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Authors:
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S N Khan; P Murray; L McCormick; L S Sharples; P Salahshouri; J Scott; P M Schofield |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Emergency medicine journal : EMJ Volume: 26 ISSN: 1472-0213 ISO Abbreviation: Emerg Med J Publication Date: 2009 Jun |
Date Detail:
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Created Date: 2009-05-25 Completed Date: 2009-11-23 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 100963089 Medline TA: Emerg Med J Country: England |
Other Details:
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Languages: eng Pagination: 452-5 Citation Subset: IM |
Affiliation:
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Department of Cardiology, Papworth Hospital, Papworth Everard, Cambridge, UK. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Delivery of Health Care / standards* Emergency Medical Services / standards* Emergency Medical Technicians* England Female Fibrinolytic Agents / therapeutic use* Humans Male Middle Aged Myocardial Infarction / drug therapy*, mortality Thrombolytic Therapy / standards Time Factors Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Fibrinolytic Agents |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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