N Castle1, R Owen, R Vincent, N Ineson. 1. Emergency Medical Care and Rescue, Durban Institute of Technology, Durban, South Africa. nicholas.castle@fph-tr.nhs.uk
Abstract
OBJECTIVE: To apply the Joint Royal College Ambulance Liaison Committee (JRCALC) checklist to patients who were deemed eligible for thrombolytic therapy on arrival in an Accident & Emergency Department (A&E) to determine the proportion suitable for prehospital thrombolysis. DESIGN: Retrospective descriptive analysis. METHODS: The clinical notes of all patients thrombolysed in an A&E department in a year were reviewed against the JRCALC guidelines for prehospital thrombolysis. RESULTS: 14.2% of patients eligible for thrombolysis in a district general hospital were deemed suitable for prehospital thrombolysis according to the JRCALC criteria. The most common exclusion criteria were hyper/hypotension (50%), onset of symptoms (pain) >6 h previously (41.7%), or age >75 years (37%). Two or more contraindications to prehospital thrombolysis were present in 63.9% of patients. CONCLUSION: The JRCALC guidelines are an effective tool for identifying patients with potential contraindications to thrombolysis.
OBJECTIVE: To apply the Joint Royal College Ambulance Liaison Committee (JRCALC) checklist to patients who were deemed eligible for thrombolytic therapy on arrival in an Accident & Emergency Department (A&E) to determine the proportion suitable for prehospital thrombolysis. DESIGN: Retrospective descriptive analysis. METHODS: The clinical notes of all patients thrombolysed in an A&E department in a year were reviewed against the JRCALC guidelines for prehospital thrombolysis. RESULTS: 14.2% of patients eligible for thrombolysis in a district general hospital were deemed suitable for prehospital thrombolysis according to the JRCALC criteria. The most common exclusion criteria were hyper/hypotension (50%), onset of symptoms (pain) >6 h previously (41.7%), or age >75 years (37%). Two or more contraindications to prehospital thrombolysis were present in 63.9% of patients. CONCLUSION: The JRCALC guidelines are an effective tool for identifying patients with potential contraindications to thrombolysis.
Authors: W D Weaver; M S Eisenberg; J S Martin; P E Litwin; S M Shaeffer; M T Ho; P Kudenchuk; A P Hallstrom; M D Cerqueira; M K Copass Journal: J Am Coll Cardiol Date: 1990-04 Impact factor: 24.094
Authors: W B Gibler; D J Kereiakes; E N Dean; L Martin; L Anderson; C W Abbottsmith; J Blanton; D Blanton; J A Morris; C D Gibler Journal: Am Heart J Date: 1991-01 Impact factor: 4.749