Pre-hospital thrombolysis for patients with STEMI

CPD hours:

The time needed to achieve reperfusion is directly related to the extent of tissue damage and short- and long-term outcomes associated with ST elevation myocardial infarction (STEMI).

Reperfusion is the process of restoring blood flow to the myocardium.

It may occur through thrombolysis, which involves intravenous administration of an effective clot-dissolving (fibrinolytic) agent or by primary percutaneous coronary intervention, often involving angioplasty and stenting.

Primary percutaneous coronary intervention (PCI), if performed in a timely manner, is the preferred reperfusion strategy for patients with an ST-segment elevation myocardial infarction (STEMI). However, for areas that are geographically isolated from a primary PCI centre or where PCI cannot be performed rapidly, pre-hospital thrombolysis can reduce the time to cardiac reperfusion.

The following module aims to improve understanding of pre-hospital thrombolysis, including its:

Advantages and disadvantages,

Clinical considerations, and

Complications associated the administration of fibrinolytics.

Note that pre-hospital thrombolysis is NOT available in all regions of Australia. The following clinical information is designed to improve background knowledge and help RNs prepare for the use of PHT.

All practitioners should refer to their local policies for the appropriate management of STEMIs in their practice areas.

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At the end of this module participants will be able to:

  • Understand the advantages and disadvantages of pre-hospital thrombolysis.
  • Understand the clinical considerations associated with thrombolysis including clinical assessment, indications and contraindications of treatment, drug administration, and patient monitoring.
  • Outline the potential complications of pre-hospital thrombolysis.

At the end of this module participants will be able to:

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