Document Detail

Paramedic-led prehospital thrombolysis is safe and effective: the East Anglian experience.
MedLine Citation:
PMID:  19465626     Owner:  NLM     Status:  MEDLINE    
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.
S N Khan; P Murray; L McCormick; L S Sharples; P Salahshouri; J Scott; P M Schofield
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Emergency medicine journal : EMJ     Volume:  26     ISSN:  1472-0213     ISO Abbreviation:  Emerg Med J     Publication Date:  2009 Jun 
Date Detail:
Created Date:  2009-05-25     Completed Date:  2009-11-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100963089     Medline TA:  Emerg Med J     Country:  England    
Other Details:
Languages:  eng     Pagination:  452-5     Citation Subset:  IM    
Department of Cardiology, Papworth Hospital, Papworth Everard, Cambridge, UK.
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MeSH Terms
Aged, 80 and over
Delivery of Health Care / standards*
Emergency Medical Services / standards*
Emergency Medical Technicians*
Fibrinolytic Agents / therapeutic use*
Middle Aged
Myocardial Infarction / drug therapy*,  mortality
Thrombolytic Therapy / standards
Time Factors
Treatment Outcome
Reg. No./Substance:
0/Fibrinolytic Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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