ORIGINAL ARTICLE

What percentages of patients are suitable for prehospital thrombolysis?

N Castle¹, R Owen², R Vincent³, N Ineson⁴

¹ Emergency Medical Care and Rescue, Durban Institute of Technology, Durban, South Africa
² Surrey Ambulance Service NHS Trust, Banstead, Surrey, UK
³ Brighton and Sussex University Hospital NHS Trust, Brighton, UK
⁴ Frimley Park Hospital NHS Trust, Frimley, Surrey, UK

Correspondence to:
Correspondence to:
N Castle
Frimley Park Hospital NHS Trust, Frimley, Surrey, UK; nicholas.castle{at}fph-tr.nhs.uk

Objective: To apply the Joint Royal College Ambulance Liaison Committee (JRCALC) checklist to patients who were deemed eligible for thrombolytic therapy on arrival in an Accident & Emergency Department (A&E) to determine the proportion suitable for prehospital thrombolysis.

Design: Retrospective descriptive analysis.

Methods: The clinical notes of all patients thrombolysed in an A&E department in a year were reviewed against the JRCALC guidelines for prehospital thrombolysis.

Results: 14.2% of patients eligible for thrombolysis in a district general hospital were deemed suitable for prehospital thrombolysis according to the JRCALC criteria. The most common exclusion criteria were hyper/hypotension (50%), onset of symptoms (pain) >6 h previously (41.7%), or age >75 years (37%). Two or more contraindications to prehospital thrombolysis were present in 63.9% of patients.

Conclusion: The JRCALC guidelines are an effective tool for identifying patients with potential contraindications to thrombolysis.

Keywords: bolus; JRCALC; prehospital; thrombolysis

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

Relevant Article

Primary Survey

Colville Laird
Emerg. Med. J. 2006 23: 415. [Extract] [Full Text] [PDF]

This article has been cited by other articles:

• Khan, S N, Murray, P, McCormick, L, Sharples, L S, Salahshouri, P, Scott, J, Schofield, P M (2009). Paramedic-led prehospital thrombolysis is safe and effective: the East Anglian experience. Emerg. Med. J. 26: 452-455 [Abstract] [Full Text]  
• McLean, S, Egan, G, Connor, P, Flapan, A D (2008). Collaborative decision-making between paramedics and CCU nurses based on 12-lead ECG telemetry expedites the delivery of thrombolysis in ST elevation myocardial infarction. Emerg. Med. J. 25: 370-374 [Abstract] [Full Text]  
• Castle, N R, Owen, R C, Hann, M (2007). Is there still a place for emergency department thrombolysis following the introduction of the amended Joint Royal Colleges Ambulance Liaison Committee criteria for thrombolysis?. Emerg. Med. J. 24: 843-845 [Abstract] [Full Text]