rss
Emerg Med J 2006;23:650-653 doi:10.1136/emj.2005.033993
  • Prehospital care

Identifying barriers to prehospital thrombolysis in the treatment of acute myocardial infarction

  1. T C Hanson1,
  2. D Williamson2
  1. 1Bristol University Medical School, Bristol, UK
  2. 2Emergency Department, Royal United Hospital, Bath, UK
  1. Correspondence to:
 Dr D Williamson
 Consultant Emergency Medicine, Emergency Department, Royal United Hospital, Combe Park, Bath BA1 3NG, UK; dominic.williamson{at}ruh-bath.swest.nhs.uk
  • Accepted 18 April 2006

Abstract

Background and objectives: After an acute myocardial infarction (AMI) prehospital thrombolysis (PHT) reduces mortality compared with inhospital thrombolysis. In practice, a relatively small proportion of the total population with AMI receives PHT. This study was designed to identify the current barriers to PHT.

Methods: A retrospective practice review of 57 consecutive patients treated in or before arrival at a district general hospital emergency department. All patients received thrombolysis for an AMI.

Results: The main barriers to delivery of PHT appear to be the inclusion and exclusion criteria laid out in the ambulance service central guidelines. Despite recent widening of the inclusion criteria, 54% of patients eligible for immediate treatment on arrival in hospital either received or were eligible for PHT.

Conclusion: To increase the number of patients who are eligible for PHT these guidelines need to be revised further in line with inhospital criteria for thrombolysis.

Footnotes

  • Competing interests: none declared

  • Ethical approval was not required for this study.

Responses to this article

  • Bringing pre-hospital thrombolysis closer to hospital practice
    • Tom Quinn
    Emerg Med J published online August 1, 2006

This Article

  1. Abstract
  2. Full text
  3. PDF

Register for free content


Free trial
Individuals may register for a free 60 day online trial to all content.

Free archive
The full back archive is now available for all BMJ Journals. Institutional subscribers may access the entire archive as part of their subscription. Personal subscribers will also have access to all content when logged in. Non-subscribers who register have free access to all articles published before 2006 right back to volume 1 issue 1. Register here to access the free archive of all BMJ Journals.

Don't forget to sign up for content alerts so you keep up to date with all the articles as they are published.