Hi Adrian,
What I'm suggesting is that thrombolysis targets have obscured the fact
that the gold standard is angioplasty - that is where we should be
ploughing our resources.
Facilitated thrombolysis is low does thrombolysis in the field prior to
angiolasty (which by definition is then no longer primary).
Disagree that not enough cardiologists - if each major London hospital
were on take for one night a week, London could have a primary
angioplasty service. There are enough cardiologists, they are just
spread between a range of hospitals. DGH cardiologists in our patch
already do on-call rota for referral hospital with cath lab.
Cheers
Anton
Adrian Fogarty wrote:
>
> I'm not exactly sure what you're advocating in this message, Anton, i.e.
> what do you mean by "who needs targets" and what do you mean by "facilitated
> thrombolysis"? Anyway, from a purely practical viewpoint, it would be next
> to impossible to treat all MIs by primary angioplasty in this country -
> evidence or no evidence - for the foreseeable future.
>
> Adrian Fogarty
>
> ----- Original Message -----
> From: "Anton van Dellen" <[log in to unmask]>
> To: <[log in to unmask]>
> Sent: Sunday, September 21, 2003 8:31 PM
> Subject: Re: ECGs at the scene for thrombolysis
>
> > As stated by Mike, an interesting debate ...
> >
> > Suffice it to say that running on blues for the 90% of patients with
> > chest pains who are NOT having an MI is not exactly a firm favourite of
> > our crews ...
> >
> > If we are going to be evidence based, I think the evidence points
> > towards primary angioplasty being superior to thrombolysis - that is
> > certainly the message when we benchmark with US services.
> >
> > In which case, the reason we take a 12 lead pre-hospital is to determine
> > whether we are going to go straight to a cath lab.
> >
> > 3 cases thusfar, one by heli and a door to cath time of 7 minutes with
> > the heli one.
> >
> > Who needs targets ...
> >
> > Next stage facilitated thrombolysis ...
> >
> > Anton
> > Staffs
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