CMAJ. 1996 Feb 15;154(4):483-7.
To recommend practical steps to ensure early thrombolytic therapy and thereby reduce mortality and morbidity associated with acute myocardial infarction (AMI).
Various factors were considered that influence time to thrombolysis related to patients, independent practitioners and health care systems.
Reduction in morbidity and mortality associated with AMI.
Early initiation of thrombolytic therapy reduces morbidity and mortality associated with AMI. The ECC Coalition analysed the factors that might impede early implementation of thrombolytic therapy.
Published data were reviewed, and recommendations were based on consensus opinion of the Emergency Cardiac Care (ECC) Coalition. The ECC Coalition comprises 20 professional, nongovernment and government organizations and has a mandate to improve emergency cardiac care services through collaboration.
BENEFITS, HARMS AND COSTS: Early thrombolytic therapy reduces morbidity and mortality associated with AMI. Implementation of the recommendations will result in reduced time to thrombolytic therapy, streamlining of current practices and enhanced cooperation among health care professionals to expedite care. Depending on existing practices, implementation may require protocol development, and public and professional education. Although costs are associated with educating the public and health care professionals, they are outweighed by the financial and social benefits of reduced morbidity and mortality.
Early recognition of AMI symptoms by the public and health care professionals, early access to the emergency medical services system and early action by emergency care providers in administering thrombolytic therapy (within 30 minutes after the patient's arrival at the emergency department).
No similar consensus statements or practice guidelines for thrombolytic therapy in Canada are available for comparison.
推荐切实可行的措施以确保早期溶栓治疗，从而降低与急性心肌梗死（AMI）相关的死亡率和发病率。
考虑了各种影响患者、独立从业者和医疗保健系统溶栓时间的因素。
降低与AMI相关的发病率和死亡率。
早期开始溶栓治疗可降低与AMI相关的发病率和死亡率。急诊心脏护理联盟分析了可能阻碍早期实施溶栓治疗的因素。
对已发表的数据进行了审查，并根据急诊心脏护理（ECC）联盟的共识意见提出了建议。ECC联盟由20个专业、非政府和政府组织组成，其任务是通过合作改善急诊心脏护理服务。
益处、危害和成本：早期溶栓治疗可降低与AMI相关的发病率和死亡率。实施这些建议将缩短溶栓治疗时间，简化现有做法，并加强医疗保健专业人员之间的合作以加快治疗。根据现有做法，实施可能需要制定方案以及开展公众和专业教育。虽然对公众和医疗保健专业人员进行教育会产生成本，但降低发病率和死亡率带来的经济和社会效益超过了这些成本。
公众和医疗保健专业人员应尽早识别AMI症状，尽早接入紧急医疗服务系统，以及急诊护理人员应尽早采取行动进行溶栓治疗（患者到达急诊科后30分钟内）。
加拿大没有可供比较的类似溶栓治疗共识声明或实践指南。
