Thrombolytic therapy

Mickey S. Eisenberg, Richard V. Aghababian, Leo Bossaert, Allan S. Jaffe, Joseph P. Ornato, W. Douglas Weaver

Research output: Contribution to journalArticlepeer-review

15 Scopus citations

Abstract

All patients with symptoms and ECG findings suggestive of acute myocardial infarction (AMI) should be considered for treatment with thrombolytic agents. The decision to use thrombolytic therapy is a clinical judgment based upon a weighing of the potential benefits versus the possible risks. The physician must take into account relative contraindications, age of the patient, area of jeopardized myocardium, and duration of symptoms. Health professionals involved in the care of AMI patients should develop written plans and protocols addressing the following matters: identification of patients with chest pain in the prehospital setting (this applies to hospitals that receive patients from emergency medical services systems), triage of patients in the emergency department, obtaining the 12-lead electrocardiogram, determination of contraindications, authority for ordering thrombolytic therapy, and consultation for atypical cases. There also should be agreed standards for the time interval from arrival in the ED to administration of the thrombolytic agent, as well as a commitment to the prospective monitoring of procedures and times to assure continuous improvement. A time interval for treatment (arrival in ED to administration of drug) of 30 to 60 minutes should be achievable for patients who present with typical symptoms and ECG findings.

Original languageEnglish (US)
Pages (from-to)417-427
Number of pages11
JournalAnnals of emergency medicine
Volume22
Issue number2 PART 2
DOIs
StatePublished - Feb 1993

Keywords

  • acute myocardial infarction
  • thrombolytic therapy

ASJC Scopus subject areas

  • Emergency Medicine

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