| Author/Editor | Žmavc, Andrej | |
| Title | Prve izkušnje s trombolitičnim zdravljenjem akutnega miokardnega infarkta pred prihodom v bolnišnico | |
| Translated title | The first experience on prehospital thrombolytic therapy of acute myocardial infarction | |
| Type | članek | |
| Source | In: Bručan A, Gričar M, editors. Urgentna medicina: izbrana poglavja 5. Zbornik 6. mednarodni simpozij o urgentni medicini; 1999 jun 16-19; Portorož. Ljubljana: Slovensko združenje za urgentno medicino, | |
| Publication year | 1999 | |
| Volume | str. 229-36 | |
| Language | slo | |
| Abstract | In order to achieve effective thrombolysis in acute myocardial infarction (AMI) the most important goal is the early treatment. Besides shortening the door-to-needle time, a prehospital thrombolysis (PT) is becoming more and more important. A prerequisite for PT is a well established prehospital EMS system. A precise protocol for the PT should encompass not only the clinical inclusion criteria but also a time criterion based on time gain achieved by PT. In a twenty-month period (from July 97 to February 99) five PTs were performed in prehospital EMS unit in Celje (8% of patients with AMI or suspected AMI). In all five patients the treatment was successful and with no complications. The average age of patients was 59 years, the average duration of symptoms until the EMS team arrived was 60 min., the average pre-hospital intervention time was 52 min., the average time gain was 30 min. In seven patients (11 % of patients with AMI or suspected AMI) PT was indicated but not performed due to some technical problems and some personnel misjudgments as well. Because the number of patients is so small, statistical analysis is not possible nor sensible, therefore only the feasibility of the PT is emphasized. As a thrombolytic agent we used streptokinase in a 60-min. infusion protocol. Reteplase has an advantage over streptokinase in a prehospital setting, but unfortunately currently it is the price that disables its use in our EMS system. By our experience we can conclude that PT is feasible in Slovenia, only in some regions yet , but very soon due to the Slovenian EMS system project, the same might be conceivable for the entire country. | |
| Descriptors | MYOCARDIAL INFARCTION EMERGENCY MEDICAL SERVICES THROMBOLYTIC THERAPY STREPTOKINASE ALTEPLASE |