Joint Royal Colleges Ambulance Liaison Committee

Prehospital Thrombolysis Survey

COMPARISON OF RESULTS 2001/2002

The Five Models that may be adopted by Ambulance Trusts to speed thrombolysis are:-

1.Recognition of eligibility for thrombolysis by paramedics (based on clinical features and the ECG).

No transmission of data but the A/E department or CCU will be alerted.

2.As above (Model 1), but in addition with transmission of clinical information and the ECG so that the hospital has all relevant details for clinical decision before patient's arrival.

3.As above (Model 2), but with direct contact with a physician who might then authorise the prehospital administration of a thrombolytic drug on a named patient basis.

4.Co-operation in rural areas with primary care physicians who will administer the agents in the patient's home, within the ambulance, or in local community hospitals before transfer to a DGH.

5.Administration of thrombolytics by trained paramedics acting autonomously, either using streptokinase (available under the PMO arrangements) or reteplase using Patient Group Directions.

RESULTS IN MAY 2002

Note: Streptokinase, reteplase and tenecteplase were specified in May 2002 survey.

In the returns received, tenecteplase was ticked more frequently than the other two as the thrombolytic of choice

 

MODEL 1

MODEL 2

MODEL 3

MODEL 4

MODEL 5

Thrombolytic Agent

 

Now

Future

Now

Future

Now

Future

Now

Future

Now

Future

Streptokinase

Reteplase

Tenecteplase

TOTALS

17

8

9

14

+1 poss

2

10

4

4

4

11

+2 poss

1

7

19

  Are all front-line ambulances equipped with 12-lead ECGs? If no, is it your Trust's intention to equip all front-line ambulances in 2002? Are all paramedics trained in 12-lead interpretation? If no, are some paramedics trained? If no, are you intending to start training in 2002?
TOTALS 29 (N);  6 (Y) 6(N); 21(Y); +2 need funding 29 (N);  7  (Y) 10 (N); 22 (Y) 2 (N); 18 (Y)

RESULTS IN MAY 2001

Note: The only thrombolytic agents requested to specify in May 2001 survey were streptokinase and reteplase, but 2 Trusts mentioned tenecteplase in their returns.

 

MODEL 1

MODEL 2

MODEL 3

MODEL 4

MODEL 5

Thrombolytic Agent

 

Now

Future

Now

Future

Now

Future

Now

Future

Now

Future

Streptokinase

Reteplase

Tenecteplase

TOTALS

11

10

10

15

2

18

2

7

1

12

4 + 3 poss.

20 + 3 poss.

2


Home About JRCALC Publications Guidelines News
Main Committee Sub-Committees Conferences Contact Details Links

Site designed and maintained by Stuart Nicholls