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    Paramedic administration of glycoprotein inhibitors for ST elevation myocardial infarction

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    Author
    Dykes, Simon
    Keyword
    Myocardial Infarction
    Acute Coronary Syndrome
    Cardiac Arrest
    ST-segment Elevation Myocardial Infarction (STEMI)
    Percutaneous Coronary Intervention
    Journal title
    Journal of Paramedic Practice
    
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    URI
    http://hdl.handle.net/20.500.12417/613
    DOI
    10.12968/jpar.2012.4.3.155
    Abstract
    Abstract published with permission. Until recently, paramedics were routinely delivering out-of-hospital thrombolysis for ST segment elevation myocardial infarction (STEMI). Now that primary percutaneous coronary intervention (PPCI) is the favoured reperfusion strategy, STEMI patients are by-passing the local emergency department and taken directly to the catheterisation laboratory via ambulance. STEMI patients within a rural setting are facing the prospect of extended transfer times for reperfusion of an already ischaemic myocardium, a potentially perilous strategy. Empirical research conducted outside the UK has identified that the pre-hospital administration of a glycoprotein inhibitor improves clinical outcome for STEMI patients. Glycoprotein naturally helps to build the fibrin mesh essential within the clotting process. Inhibition of this process by glycoprotein inhibitors IIb/IIIa (GPI IIb/IIIa) prevents aggregation at receptor sites on platelets. Original research supports the notion that GPI IIb/IIIa involvement improves patient clinical outcome for STEMI in the out-of-hospital phase. Paramedics are typically the first contact for the STEMI patient and it is tangible that paramedics have the appropriate skill and knowledge to diagnose the out-of-hospital STEMI. With this in mind, it is the purpose of this article to discuss the use of pre-hospital GPI IIb/IIIa administration and to argue that this intervention should be administered by paramedic personnel.
    ae974a485f413a2113503eed53cd6c53
    10.12968/jpar.2012.4.3.155
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