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Emergency Medicine Journal 2002;19:444-447; doi:10.1136/emj.19.5.444
© 2002 BMJ Publishing Group Ltd and the College of Emergency Medicine.
Emerg Med J 2002; 19:444-447
© 2002 the Emergency Medicine Journal

PERSONAL VIEW

Is prehospital thrombolysis for acute myocardial infarction warranted in the urban setting? The case against

D T Stephenson1, J W Wardrope2 and S W Goodacre3

1 Accident and Emergency Department, Northern General Hospital, Sheffield, UK
2 South Yorkshire Ambulance Service, UK
3 Health Services Research Fellow, Medical Care Research Unit, Sheffield University, UK

Correspondence to:
Correspondence to:
Dr D T Stephenson, Accident and Emergency Department, Northern General Hospital, Herries Road, Sheffield S5 7AU, UK;
danieltstephenson{at}yahoo.com

ABSTRACT

This paper forms the second part of the debate on prehospital thrombolysis (PHT). It is argued that large scale studies have failed to show a benefit for PHT, even when the time saved over conventional treatment was considerably greater than would be the case in the UK urban setting. In practice, a relatively small proportion of the total population receiving thrombolysis would receive PHT. Other strategies to reduce time to thrombolysis can benefit all patients and are likely to be more cost effective and safer.

Keywords: thrombolysis

Abbreviations: AMI, acute myocardial infarction; PHT, prehospital thrombolysis


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This article has been cited by other articles:

  • Castle, N, Owen, R, Vincent, R, Ineson, N (2006). What percentages of patients are suitable for prehospital thrombolysis?. Emerg. Med. J. 23: 444-445 [Abstract] [Full Text]  
  • Benger, J R (2002). Commentary. Emerg. Med. J. 19: 447-448 [Full Text]  

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