[General practitioner-based prehospital thrombolysis in acute myocardial infarction].
BACKGROUND
If properly organised, prehospital thrombolysis in acute myocardial infarction saves time to treatment and improves outcome. We have evaluated a quality assurance program for general practitioner-based (GP-based) prehospital thrombolysis.


METHODS
GPs and the local ambulance service in eight local communities went through a one-day training programme. The GPs interpreted the ECGs themselves and initiated prehospital thrombolysis according to a set of criteria. Patients with prehospital thrombolysis were prospectively compared with patients receiving hospital thrombolysis during the same time period.


RESULTS
From 1999 to 2001, 69 patients received prehospital thrombolysis: 50% of all patients receiving thrombolysis. No complications were attributed to prehospital administration; 66 out of 69 patients received thrombolysis on a correct indication. The median call to needle time was reduced from 145 to 63 minutes in patients treated before arrival at a hospital, which gives a median of 82 minutes of time saved.


CONCLUSIONS
GP-initiated prehospital thrombolysis is safe after proper training and saves clinically important time to treatment compared with hospital administration.
Hole
Torstein
T
Medisinsk avdeling, Alesund sjukehus, Helse Sunnmøre, 6026 Alesund. torstein.hole@helse-sunnmore.no
Juvkam
Per Christian
PC
Lied
Arne
A
D000328:Adult; D000368:Aged; D000552:Ambulances / Q000458:organization & administration / Q000592:standards; D002983:Clinical Competence; D000075202:Contraindications; D004502:Education, Medical, Continuing; D004562:Electrocardiography / Q000592:standards; D004632:Emergency Medical Services / Q000458:organization & administration / Q000592:standards; D005194:Family Practice / Q000193:education / Q000592:standards; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000188:drug therapy*; D009664:Norway; D011446:Prospective Studies; D011785:Quality Assurance, Health Care; D015912:Thrombolytic Therapy / Q000592:standards; D016896:Treatment Outcome