Abstract:
BACKGROUND:Fibrinolysis is an acceptable treatment for acute ST-segment elevation myocardial infarction (STEMI) when primary percutaneous coronary intervention (PCI) cannot be performed within 120 minutes. The American Heart Association has recommended Emergency Medical Services (EMS) interventions such as prehospital fibrinolysis (PHF), prehospital electrocardiogram (ECG), and hospital bypass direct to PCI center. Nova Scotia, Canada has incorporated these interventions into a unique province-wide approach to STEMI care. A retrospective cohort analysis comparing the primary outcome of 30-day mortality for patients receiving either prehospital or emergency department (ED) fibrinolysis (EDF) to patients transported directly by EMS from community or regional ED for primary PCI was conducted. METHODS:This retrospective, population-based cohort study included all STEMI patients in Nova Scotia who survived to hospital admission from July 2011 through July 2013. Three provincial databases were used to collect demographic, 30-day mortality, hospital readmission, and rescue PCI data. The results were grouped and compared according to reperfusion strategy received: PHF, EDF, patients brought by ambulance via EMS direct to PCI (EMS to PCI), and ED to PCI (ED to PCI). RESULTS:There were 1,071 STEMI patients included with 145 PHF, 606 EDF, 98 EMS to PCI, and 222 ED to PCI. There were no significant differences in 30-day mortality across groups (n, %): PHF 5(3); EDF 36(6); EHS to PCI <5(2); and ED to PCI 10(4); P = .28. There was no significant difference in patients receiving fibrinolysis who underwent rescue PCI. CONCLUSIONS:Prehospital fibrinolysis incorporated into a province-wide approach to STEMI treatment is feasible with no observed difference in patient 30-day mortality outcomes observed.
journal_name
Prehosp Disaster Medjournal_title
Prehospital and disaster medicineauthors
Cook J,Carter A,Goldstein J,Travers A,Brown R,Swain J,Jensen J,Matheson K,Cain E,Lee Tdoi
10.1017/S1049023X20000801subject
Has Abstractpub_date
2020-10-01 00:00:00pages
528-532issue
5eissn
1049-023Xissn
1945-1938pii
S1049023X20000801journal_volume
35pub_type
杂志文章abstract::The tasks required for the preservation of the health of rescuers can be accomplished with the creation of a system for medical examinations and rehabilitation that functions with commonly used methodological and organizational principles. Absence of such a common methodological platform often results in the disqualif...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:
更新日期:1999-07-01 00:00:00
abstract:INTRODUCTION:Mildly injured and "worried well" patients can have profound effects on the management of a mass-casualty incident. The objective of this study is to describe the characteristics and lessons learned from an event that occurred on 28 August 2005 near the central bus station in Beer-Sheva, Israel. The unique...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:10.1017/s1049023x00004623
更新日期:2007-05-01 00:00:00
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pub_type: 杂志文章
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journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:10.1017/S1049023X19005089
更新日期:2020-02-01 00:00:00
abstract::The detonation of a bomb in a shopping center in Vantaa, Finland, took place on 11 October 2002. Seven people died as a result and > 160 people required medical attention. Because the rescue teams were inadequately trained to respond to terrorist attacks, the event was handled according to protocol. A number of proble...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:10.1017/s1049023x00004404
更新日期:2007-01-01 00:00:00
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journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:10.1017/S1049023X20000102
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journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:10.1017/s1049023x00002284
更新日期:2005-03-01 00:00:00
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journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:10.1017/S1049023X11000124
更新日期:2011-04-01 00:00:00
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journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:10.1017/S1049023X18000808
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journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:10.1017/S1049023X16000285
更新日期:2016-06-01 00:00:00
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journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:10.1017/s1049023x00008505
更新日期:2010-09-01 00:00:00
abstract:INTRODUCTION:Emergency pediatric life support (EPLS) of children infected with transmissible respiratory diseases requires adequate respiratory protection for medical first responders. Conventional air-purifying respirators (APR) and modern loose-fitting powered air-purifying respirator-hoods (PAPR-hood) may have a dif...
journal_title:Prehospital and disaster medicine
pub_type: 杂志文章,随机对照试验
doi:10.1017/S1049023X12001525
更新日期:2013-02-01 00:00:00
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journal_title:Prehospital and disaster medicine
pub_type: 临床试验,杂志文章
doi:
更新日期:1997-07-01 00:00:00
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journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:10.1017/s1049023x00021257
更新日期:2008-07-01 00:00:00
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journal_title:Prehospital and disaster medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1017/s1049023x00001333
更新日期:2003-10-01 00:00:00
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journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
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更新日期:2018-06-01 00:00:00
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journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:10.1017/S1049023X15004793
更新日期:2015-08-01 00:00:00
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journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:10.1017/S1049023X12001100
更新日期:2012-10-01 00:00:00
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journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
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更新日期:2016-02-01 00:00:00
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journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
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更新日期:2016-06-01 00:00:00
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journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:10.1017/S1049023X18000183
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journal_title:Prehospital and disaster medicine
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更新日期:2020-06-01 00:00:00
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journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
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更新日期:2012-12-01 00:00:00
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journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:10.1017/S1049023X17000115
更新日期:2017-06-01 00:00:00
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journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:10.1017/s1049023x00003836
更新日期:2006-07-01 00:00:00
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journal_title:Prehospital and disaster medicine
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更新日期:2021-01-29 00:00:00
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journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
doi:10.1017/s1049023x00001977
更新日期:2004-10-01 00:00:00
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journal_title:Prehospital and disaster medicine
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更新日期:2018-08-01 00:00:00
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journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
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journal_title:Prehospital and disaster medicine
pub_type: 杂志文章
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更新日期:2012-02-01 00:00:00