BMJ  2003;327:27-28 (5 July), doi:10.1136/bmj.327.7405.27

Paper

Safety and feasibility of prehospital thrombolysis carried out by paramedics

¹ South Devon Healthcare Trust, Lawes Bridge, Torquay TQ2 7AA, ² Research and Development Support Unit, Peninsula Medical School, Plymouth PL6 8BX, ³ Department of Mathematics and Statistics, University of Plymouth, Plymouth PL4 8AA

The first 150 words of the full text of this article appear below.

Introduction

The benefits of thrombolysis in patients with acute myocardial infarction are time dependent, with a potential 48% reduction in mortality if treatment is received within an hour of onset of symptoms.¹ The benefits diminish thereafter. However the "call to needle" standard set by the national service framework² has been achieved for only a third of patients nationally because of lengthy ambulance journeys and delays in hospital. Prehospital thrombolysis may be the most feasible means of achieving timely reperfusion, and all published studies have shown the accuracy of diagnosis, patient selection, and administration of thrombolysis.³ The Joint Royal Colleges Ambulance Liaison Committee favours autonomous prehospital thrombolysis by paramedics as a long term objective.⁴ We tested the feasibility of physician assisted and autonomous models of paramedic prehospital thrombolysis.

View this table: [in this window] [in a new window]   Summary statistics for time from event to response (minutes)

 

Methods and results

All 64 paramedics serving the study hospital took part in the study. Of these, 48 . . . [Full text of this article]

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