Winst van prehospitale trombolyse bij de behandeling van het acute myocardinfarct

- Randomized studies comparing early and late thrombolysis in the treatment of acute myocardial infarction show that mortality is lower if therapy is administered at an early stage, and especially if it is administered during the first hour of symptoms.

- Since only few patients can actually be treated within one or two hours, a search was made for time gaining strategies, including prehospital thrombolysis.

- In the region of Nijmegen, the Netherlands, it proved possible with prehospital treatment to treat 25 of the patients in the first hour after onset of ischaemic symptoms. The group given prehospital treatment included almost three times as many aborted infarctions as the group treated in hospital.

- In clinical practice, the proportion of aborted infarctions and more pronounced ECG abnormalities, namely, increase the probability of early prehospital treatment as well as the risk of death.

- Conditions of the organization of prehospital thrombolysis in a region are equipment for ECG transmission by telephone, good co-operation between cardiologists and cardiologic care units and special training of paramedics and general practitioners.