Impact of pre-hospital care in patients with acute myocardial infarction compared with those first managed in-hospital

Mathew, T

doi:10.1016/s0195-668x(02)00521-3

Cited by 33 publications

(14 citation statements)

References 23 publications

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“…Nineteen studies demonstrated significantly reduced time to treatment when fibrinolytics were given to patients with STEMI in the prehospital setting by either physicians, nurses, or paramedics (LOE 1 496,497 ; 498,499 -501 LOE 2 124,502-510 ; LOE 3 [511][512][513] ).…”

Section: Consensus On Sciencementioning

confidence: 99%

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Part 9: Acute Coronary Syndromes

Bossaert

O’Connor²,

Arntz³

et al. 2010

Circulation

103

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These experts reviewed 25 topics related to the acute initial management of acute coronary syndrome (ACS), which was further categorized as unstable angina, non-ST-elevation MI (UA/NSTEMI) and ST-elevation MI (STEMI). Topics were identified based on previous recommendations, emerging science, and clinical importance, using an iterative writing process involving all Task Force members. The Task Force reviewed the evidence specifically related to diagnosis and treatment of ACS in the out-ofhospital setting and the first hours of care in the in-hospital setting, typically in the emergency department (ED). The evidence review took place over several years, with ongoing refinement of recommendations being made as new evidence was published. The purpose of the review was to generate current, evidence-based treatment recommendations for healthcare providers who serve as the initial point of contact for patients with signs and symptoms suggestive of ACS.The following is a summary of the most important changes in recommendations for diagnosis and treatment of ACS since the last ILCOR review in 2005. 1,2• The history and physical examination, initial ECG, and initial serum biomarkers, even when used in combination, cannot be used to reliably exclude ACS in the prehospital and ED settings.• In contrast, chest pain observation protocols are useful in identifying patients with suspected ACS and patients who require admission or may be referred for provocative testing for coronary artery disease (CAD) to identify reversible ischemia. Such strategies also reduce cost by reducing unnecessary hospital admissions and improve patient safety through more accurate identification of NSTEMI and STEMI.• The acquisition of a prehospital 12-lead ECG is essential for identification of STEMI patients before hospital arrival and should be used in conjunction with pre-arrival hospital notification and concurrent activation of the catheter laboratory.• Nonphysicians can be trained to independently interpret 12-lead ECGs for the purpose of identifying patients with STEMI, provided that appropriate and reliable STEMI criteria are used. This skill is of particular value in the prehospital setting where paramedics may independently identify STEMI, thus mitigating over-reliance on ECG transmission.• Computer-assisted ECG interpretation can be used to increase diagnostic accuracy of STEMI diagnosis when used alone or in combination with ECG interpretation by a trained healthcare provider.• STEMI systems of care can be implemented to improve the time to treatment. The following measures have been shown to reduce the time to primary percutaneous coronary intervention (PPCI): institutional commitment, use of a team-based approach, arranging single-call activation of the catheterization laboratory by the emergency physician or prehospital provider, requiring the catheterization laboratory to be ready in 20 minutes, having an experienced cardiologist always available, and providing real-time data feedback.• Intravenous (IV) ␤-blockers should not be give...

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Section: Consensus On Sciencementioning

confidence: 99%

“…Eleven studies showed that a greater proportion of the patients treated with prehospital fibrinolysis had shorter duration and increased frequency of total resolution of chest pain by the time of admission, ECG resolution, and decreased mortality (LOE 1 496,499,500,514 -516 ; LOE 2 505,506,508,511,513 ).…”

Section: Consensus On Sciencementioning

confidence: 99%

Part 9: Acute Coronary Syndromes

Bossaert

O’Connor²,

Arntz³

et al. 2010

Circulation

103

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“…Pre-hospital thrombolysis can halve mortality from acute myocardial infarction. 1 In 2000, the UK Department of Health (DH) introduced a series of standards for the National Health Service for the management of specific diseases; the first of these being the National Service Framework for Coronary Heart Disease (NSF CHD). 2 Prior to this, ambulance paramedics in the UK were restricted in the clinical care they could deliver to patients suffering an ACS.…”

mentioning

confidence: 99%

Does telephone triage of emergency (999) calls using advanced medical priority dispatch (AMPDS) with Department of Health (DH) call prioritisation effectively identify patients with an acute coronary syndrome? An audit of 42 657 emergency calls to Hampshire Ambulance Service NHS Trust

Deakin¹,

Sherwood²,

Smith³

et al. 2006

Emergency Medicine Journal

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“…In the present study, 28.1% of the patients got to the hospital by ambulance, but the total time taken to start the therapy was not reduced (P=0.81). Studies have shown a reduction in mortality after thrombolytic therapy in patients that received pre-hospital care (8% versus 13%) (P = 0.04) (9)(10) .…”

Section: Discussionmentioning

confidence: 99%

Delay factors on the administration of thrombolytic therapy in patients diagnosed with acute myocardial infarction in a general hospital

Muller

Rabelo

Moraes

et al. 2008

Rev. Latino-Am. Enfermagem

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Impact of pre-hospital care in patients with acute myocardial infarction compared with those first managed in-hospital

Abstract: Consecutive patients with acute myocardial infarction seen and managed initially out-of-hospital by a physician-staffed mobile coronary care unit had significantly lower in-hospital mortality.

Cited by 33 publications

References 23 publications

Part 9: Acute Coronary Syndromes

Part 9: Acute Coronary Syndromes

Does telephone triage of emergency (999) calls using advanced medical priority dispatch (AMPDS) with Department of Health (DH) call prioritisation effectively identify patients with an acute coronary syndrome? An audit of 42 657 emergency calls to Hampshire Ambulance Service NHS Trust

Delay factors on the administration of thrombolytic therapy in patients diagnosed with acute myocardial infarction in a general hospital

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