What percentages of patients are suitable for prehospital thrombolysis?
OBJECTIVE
To apply the Joint Royal College Ambulance Liaison Committee (JRCALC) checklist to patients who were deemed eligible for thrombolytic therapy on arrival in an Accident & Emergency Department (A&E) to determine the proportion suitable for prehospital thrombolysis.


METHODS
Retrospective descriptive analysis.


METHODS
The clinical notes of all patients thrombolysed in an A&E department in a year were reviewed against the JRCALC guidelines for prehospital thrombolysis.


RESULTS
14.2% of patients eligible for thrombolysis in a district general hospital were deemed suitable for prehospital thrombolysis according to the JRCALC criteria. The most common exclusion criteria were hyper/hypotension (50%), onset of symptoms (pain) >6 h previously (41.7%), or age >75 years (37%). Two or more contraindications to prehospital thrombolysis were present in 63.9% of patients.


CONCLUSIONS
The JRCALC guidelines are an effective tool for identifying patients with potential contraindications to thrombolysis.
Castle
N
N
Emergency Medical Care and Rescue, Durban Institute of Technology, Durban, South Africa. nicholas.castle@fph-tr.nhs.uk
Owen
R
R
Vincent
R
R
Ineson
N
N
D000328:Adult; D000368:Aged; D002637:Chest Pain / Q000188:drug therapy*; D003327:Coronary Disease / Q000188:drug therapy*; D004632:Emergency Medical Services / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies; D015912:Thrombolytic Therapy