Thanks for the answer....
Yes those are veryn much my views......I am yet to see a figure for how much
more of a risk you are putting your patient at by thrombolysing them if they
are warfarinised.
As for Plasty...........well as an aside In Boston at the World ICEM this year
we toured an ED and asked what there door to needle time was to be told 45 minute....
we all felt rather superior until they said their door to Plasty time was 15
minutes.....and they had only done 1 or 2 T'lysis in the last year...We shut
up at that point.
We have some distance to go.my dept does not even have its own ECG machine during
the day !!!!
Regards
Peter
>Regarding warfarin and thrombolysis my understanding is that warfarin is a
relative contra-indication esp if INR > 3 or pt with higher risk of intracranial
bleed (ie elderly).
>Discussing with our local cardiologist they feel that primary angio is treatment
of choice unless geographically impractical - when thrombolysis should be given.
>As cardiologists regionally (and hopefully nationally) are taking more of an
acute interest should we be pushing for more primary angio when available.
>
>Regarding the mailing list, I have recently rejoined the list after several
months out (because of my inbox becoming cluttered with junk). On returning
there seems to be less coming through.
>
>Samit Mitra
>
>A&E Consultant, Middlesbrough
>
>
>
>
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