|
Author |
Jennie Helmer |
Date |
2019-11-14 |
|
Reviewer |
- |
Edited |
2020-10-22 |
Adhering to the BCEHS trial-protocol, the astute Kamloops ACP consults with the Transport Advisor Cardiologist, and then proceeds to administer Fibrinolytics in the patient-home-environment, to a STEMI patient. The receiving hospital is a non-PCI-capable hospital.
“Does the administration of pre-hospital fibrinolytics, as opposed to the administration of in-hospital fibrinolytics, to STEMI patients, improve time to treatment and therefore improve patient outcomes?”
|
Population |
Adult out-of-hospital Acute ST-Myocardial Infarction (STEMI) patient |
|
Intervention |
Pre-hospital Fibrinolytics |
|
Comparison |
In-hospital Fibrinolytics |
|
Outcome |
Time to Treatment |
Pubmed: (“Pre-Hospital” AND “ST-Elevation Myocardial Infarction”) AND (“Pre-Hospital Fibrinolytics”) OR (“In-Hospital Fibrinolytics”) AND (“Time to Treatment” OR “Improved Outcomes”)
11 Results (3 Relevant) on 2019-11-14
Currently, patients who present to Royal Inland Hospital with a STEMI are generally not meeting the 30-minute recommended first medical contact to treatment times, as recommended by the Canadian Cardiovascular Society (CCS). The earlier that appropriate treatment is initiated in Acute ST-elevation Myocardial Infarction, the better the prognosis, and the better the patient outcomes.
Where the time from First Medical Contact (FMC) to Primary Coronary Intervention (PCI) is greater than 120 minutes, fibrinolysis within 30 minutes of FMC is the recommended option (CCS, 2019) for acute STEMI patients presenting within 12 hours of symptom onset. Fibrinolytics have been shown to be safe and effective when started outside the hospital by paramedics, with a reduction in time to treatment and no increase in complications.