title: Time-consuming procedures and prehospital thrombolytic treatment.
abstract: OBJECTIVE
  To assess time-consuming procedures in the prehospital stage of acute myocardial infarction patients who had received thrombolytic therapy at the scene, and to evaluate their effect on the clinical outcome.
  
  
  METHODS
  Prospective study.
  
  
  METHODS
  Mobile intensive care unit staffed by an intern or a hospital-based physician. PARTICIPANTS AND INTERVENTIONS. Thrombolytic therapy with recombinant tissue-type plasminogen activator (total dose of 120 mg/6 hrs) was initiated at the scene in 167 patients. Treatment continued during transportation and thereafter in the cardiac care unit. During hospitalization, radionuclide ventriculograms and coronary angiography were performed in most patients.
  
  
  RESULTS
  Correct diagnosis was confirmed in 165 of 167 patients. Mean time to treatment was 96 +/- 42 (SD) mins with no significant difference between patients treated at home (n = 105) or in public places (n = 60). Global duration of treatment was significantly shorter when thrombolytic therapy was given in public as compared with treatment applied at home (50 +/- 13 vs. 57 +/- 16 mins, respectively, p < .002).
  
  
  CONCLUSIONS
  If patients and physicians become aware of the potential advantages of prompt initiation of thrombolytic therapy at the scene, critical time may be saved in delivering thrombolysis to the clotted coronary artery.
authors.affiliation: Department of Cardiology, Tel-Aviv Medical Center, Israel.
authors.forename: A
authors.initials: A
authors.lastname: Roth
authors.forename: H
authors.initials: H
authors.lastname: Hod
authors.forename: H I
authors.initials: HI
authors.lastname: Miller
authors.forename: A
authors.initials: A
authors.lastname: Glick
authors.forename: B
authors.initials: B
authors.lastname: Shargorodski
authors.forename: E
authors.initials: E
authors.lastname: Kaplinsky
authors.forename: S
authors.initials: S
authors.lastname: Laniado
mesh_terms: D004632:Emergency Medical Services; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D008952:Mobile Health Units; D009203:Myocardial Infarction / Q000175:diagnosis / Q000188:drug therapy*; D011446:Prospective Studies; D015912:Thrombolytic Therapy / Q000009:adverse effects; D013997:Time Factors; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use; D014187:Transportation of Patients
chemical_list: D010959:Tissue Plasminogen Activator