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dc.contributor.authorKhan, S. N.
dc.contributor.authorMurray, Paul
dc.contributor.authorMcCormick, L.
dc.contributor.authorSharples, L. S.
dc.contributor.authorSalahshouri, P.
dc.contributor.authorScott, Jason
dc.contributor.authorSchofield, P. M.
dc.date.accessioned2020-07-28T13:30:38Z
dc.date.available2020-07-28T13:30:38Z
dc.date.issued2009-05-22
dc.identifier.citationKhan, S. N. et al, 2009. Paramedic-led prehospital thrombolysis is safe and effective: the East Anglian experience. Emergency Medicine Journal, 26 (6), 452-455.en_US
dc.identifier.issn1472-0213
dc.identifier.issn1472-0205
dc.identifier.doi10.1136/emj.2008.062729
dc.identifier.urihttp://hdl.handle.net/20.500.12417/848
dc.description.abstractIntroduction: Prehospital thrombolysis has been shown to improve patient outcomes in clinical trials and this has been confirmed in the ongoing large national myocardial infarction registry (Myocardial Infarction National Audit Project; MINAP) reports. This paper describes a system to improve the delivery of prehospital thrombolysis and the associated governance requirements to gain maximum patient benefit. Methods: Demographic data were prospectively collected on all patients treated by the East Anglian Ambulance Trust with bolus thrombolytics for a presumed diagnosis of ST elevation myocardial infarction between November 2003 and February 2007. Survival status was determined from the NHS strategic tracing service. Results: 1062 patients (mean age 64.0 years (SD 10.6), 795 men) were treated in this time period. There were 71 deaths in this group, with actuarial survival of 93.9% (SE 0.9%) at 30 days, 91.7% (SE 1.0%) at 6 months and 90.8% (SE 1.1%) at 12 months after treatment. Age and cardiac arrest were most strongly associated with mortality (both p<0.001). Twelve (1.2%) patients received thrombolysis that on review was considered inappropriate. There were no deaths in this subgroup. Conclusions: Prehospital thrombolysis can be administered safely by ambulance staff supported by a Trust clinical support system with excellent clinical outcomes. https://emj.bmj.com/content/26/6/452. This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ DOI http://dx.doi.org/10.1136/emj.2008.062729
dc.language.isoenen_US
dc.subjectEmergency Medical Servicesen_US
dc.subjectPre-hospital Careen_US
dc.subjectThrombolysisen_US
dc.subjectMyocardial Infarctionen_US
dc.subjectST-segment Elevation Myocardial Infarction (STEMI)en_US
dc.titleParamedic-led prehospital thrombolysis is safe and effective: the East Anglian experienceen_US
dc.typeJournal Article/Review
dc.source.journaltitleEmergency Medicine Journalen_US
dcterms.dateAccepted2020-07-20
rioxxterms.versionNAen_US
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserveden_US
rioxxterms.licenseref.startdate2020-07-20
refterms.panelUnspecifieden_US
refterms.dateFirstOnline2009-05-22
html.description.abstractIntroduction: Prehospital thrombolysis has been shown to improve patient outcomes in clinical trials and this has been confirmed in the ongoing large national myocardial infarction registry (Myocardial Infarction National Audit Project; MINAP) reports. This paper describes a system to improve the delivery of prehospital thrombolysis and the associated governance requirements to gain maximum patient benefit. Methods: Demographic data were prospectively collected on all patients treated by the East Anglian Ambulance Trust with bolus thrombolytics for a presumed diagnosis of ST elevation myocardial infarction between November 2003 and February 2007. Survival status was determined from the NHS strategic tracing service. Results: 1062 patients (mean age 64.0 years (SD 10.6), 795 men) were treated in this time period. There were 71 deaths in this group, with actuarial survival of 93.9% (SE 0.9%) at 30 days, 91.7% (SE 1.0%) at 6 months and 90.8% (SE 1.1%) at 12 months after treatment. Age and cardiac arrest were most strongly associated with mortality (both p<0.001). Twelve (1.2%) patients received thrombolysis that on review was considered inappropriate. There were no deaths in this subgroup. Conclusions: Prehospital thrombolysis can be administered safely by ambulance staff supported by a Trust clinical support system with excellent clinical outcomes. https://emj.bmj.com/content/26/6/452. This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ DOI http://dx.doi.org/10.1136/emj.2008.062729en_US


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