Engelsk titel: General practitioner-based prehospital thrombolysis in acute myocardial infarction
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Författare:
Hole T
;
Juvkam PC
;
Lied A
Email: torstein.hole@helse-sunnmore.no
Språk: Nor
Antal referenser: 15
Dokumenttyp:
Artikel
UI-nummer: 05061953
Sammanfattning
BACKGROUND : If properly organised, prehospital thrombolysis in acute myocardial infarction saves time to treatment and improves outcome. We have evaluated a quality assurance program for general practitioner-based (GP-based) prehospital thrombolysis.
MATERIAL AND METHODS : GPs and the local ambulance service in eight local communities went through a one-day training programme. The GPs interpreted the ECGs themselves and initiated prehospital thrombolysis according to a set of criteria. Patients with prehospital thrombolysis were prospectively compared with patients receiving hospital thrombolysis during the same time period.
RESULTS : From 1999 to 2001, 69 patients received prehospital thrombolysis: 50% of all patients receiving thrombolysis. No complications were attributed to prehospital administration; 66 out of 69 patients received thrombolysis on a correct indication. The median call to needle time was reduced from 145 to 63 minutes in patients treated before arrival at a hospital, which gives a median of 82 minutes of time saved.
INTERPRETATION : GP-initiated prehospital thrombolysis is safe after proper training and saves clinically important time to treatment compared with hospital administration.