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What percentages of patients are suitable for prehospital thrombolysis?
  1. N Castle1,
  2. R Owen2,
  3. R Vincent3,
  4. N Ineson4
  1. 1Emergency Medical Care and Rescue, Durban Institute of Technology, Durban, South Africa
  2. 2Surrey Ambulance Service NHS Trust, Banstead, Surrey, UK
  3. 3Brighton and Sussex University Hospital NHS Trust, Brighton, UK
  4. 4Frimley Park Hospital NHS Trust, Frimley, Surrey, UK
  1. Correspondence to:
 N Castle
 Frimley Park Hospital NHS Trust, Frimley, Surrey, UK; nicholas.castle{at}


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.

  • bolus
  • prehospital
  • thrombolysis

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  • Competing interests: none declared

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