Chest pain + no ST elevation + rural location + positive enzymes =
prehospital thrombolysis?????????
Some ambualnce services (even urban ones) do well to get patient to hospital
in under 45 minutes from call.
Just a thought!!
Iain
----- Original Message -----
From: Timothy J Coats (SURG) 7728 <[log in to unmask]>
To: <[log in to unmask]>
Sent: Thursday, June 08, 2000 10:08 AM
Subject: RE: cardiac enzymes
>
> > The UK perspective is 75 minutes for call for help which may exclude
cardiac
> > enzymes out of the equation.
> > I am still convinced that they have a very definate role to play but the
A&E
> > dept in the UK are playing 'catch up' with developing technologies of
> > prehospital care. Not that long ago I was approached by an ambulance
> > technician who asked what the point of a BP and 12 lead ECG' were and
the
> > A&E nurse backed up the question. With attitudes like that I believe
that
> > TnT etc are a few years down the line. But I personnally agree that they
> > have a place in prehospital care.
>
> Could you expand on the possible place in pre-hospital care?
>
> At first glance: typical chest pain for AMI, no ST elevation on 12
> lead = still not a candidate for pre-hospital thrombolysis, so does a
> pre-hospital cardiac enzyme result actually help?
>
> How do you see a pre-hospital enzyme result changing patient
> management?
>
> (Practical difficulties at present - stix testing for troponins or
> myoglobin requires a heparinised venous sample and needs a 15
> minute incubation in a machine - at present no battery version).
>
> Tim
>
> Timothy J Coats MD FRCS FFAEM
> Senior Lecturer in Accident and Emergency / Pre-Hospital Care
> Royal London Hospital, UK.
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