🚀 go-pugleaf

In a previous article,  Gerald Clough  <DONTSPAMclough@texas.net> writes:
>medic13 wrote:
>Run a search on Yahoo using keywords "prehospital thrombolytic".  You'll
>find a number of studies and other reports, most demonstrating the value
>of prehospital therapy.  One of the primary reasons the urban setting is
>appropriate is the typical denial and delay in activating 9-1-1 or going
>to the hospital.  We're shooting for the first hour or two after the
>blockage, and the patients are consuming that and more in delaying
>access.  Substantial efforts are being made in the area of public
>awareness, but the unfortunate fact is that we are very often missing
>the opportunity for the best outcome and are limiting the permanent
>muscle damage, rather than preventing it
<snip>

I don't know...In the urban area, if you're medics are doing appropriate
diagnostics to determine potential lytics candidates, you can already be on
the move to the ED, which in many urban areas is no more than 10 minutes
away. As long as they know what you're coming in with, the door to drug time
can be almost eliminated (<5 minutes for most of our suspected MI patients).
And all this without increasing the patient's risk of doing something bad
(like dying) due to reperfusion dysrhythmias.

Don't get me wrong. Prehospital thrombolytics are a great idea...but one that
works best when you're not going to reach the hospital within the ideal
window...regardless of how early EMS is accessed. This means suburban/rural
is your ideal place for prehospital lytics, not the city. A BLS service I
recently did a trauma lecture for has only a clinic in their town. Nearest
hospital is 45-50 minutes away. When they have a suspected MI in progress,
they call ahead...the PA arrives at the clinic to meet them. 12 lead EKG in
the truck...if MI, the PA rides in with, beginning thrombolytics
enroute...with good success.

Frankly in our urban area (and perhaps the people in Minneapolis are more
enlightened), we either get called early (<1 hour) or very late (12-48
hours), so we can reach the hospital for lytics easily, or they're not a
candidate anyway.

Bob Ball, EMT-P
HCMC EMS/Ambulance, Minneapolis MN www.hcmc.org/depts/em/ambulance

     -----  Posted via NewsOne.Net: Free Usenet News via the Web  -----
     -----  http://newsone.net/ --  Discussions on every subject. -----
   NewsOne.Net prohibits users from posting spam.  If this or other posts
made through NewsOne.Net violate posting guidelines, email abuse@newsone.net