Hole Torstein, Juvkam Per Christian, Lied Arne
Medisinsk avdeling, Alesund sjukehus, Helse Sunnmøre, 6026 Alesund.
Tidsskr Nor Laegeforen. 2005 Jun 2;125(11):1486-8.
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.
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.
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.
GP-initiated prehospital thrombolysis is safe after proper training and saves clinically important time to treatment compared with hospital administration.
