Thrombolysis: the development of unit guidelines.
A challenge remains to develop guidelines for practice which facilitate safer and effective administration of thrombolytic agents following acute myocardial infarction. Clinical trials have proven that early reperfusion of ischaemic myocardium following rapid diagnosis, aspirin administration, analgesia and the instigation of an appropriate thrombolytic regime reduces mortality rates. Accordingly, as thrombolysis becomes the buzzword of the 1990s, controversy has resulted in substantial variations in practice of thrombolytic strategies within the UK (FTTCC 1994). The purpose of this review article is to consider the importance of current research and its application to current practices. Topics under discussion include thrombolytic agents, antistreptokinase antibody, time delay, eligibility for thrombolytic treatment, and clinically proven therapeutic regimes; with a suggested admission protocol that facilitates bi-directional communication minimising time delay and preventing inappropriate, cost-inefficient admissions to critical care areas. The results of this provide a logistical basis to thrombolytic therapy, and the subsequent development of effective and safe algorithmic guidelines in a busy medical intensive care unit.
Kynman
G
G
Intensive Care Unit, Jersey, General Hospital, St Helier, Jersey Cl, UK.
D000465:Algorithms; D003422:Critical Care; D003663:Decision Trees; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D009203:Myocardial Infarction / Q000175:diagnosis / Q000188:drug therapy*; D018579:Patient Selection; D017410:Practice Guidelines as Topic; D015912:Thrombolytic Therapy / Q000379:methods / Q000592:standards
D005343:Fibrinolytic Agents