H. Kapasi et al., Thrombolysis in the air - Air-ambulance paramedics flying to remote communities treat patients ts before hospitalization, CAN FAM PHY, 46, 2000, pp. 1313-1319
PROBLEM ADDRESSED First Nations* communities in the North have a high preva
lence of coronary artery disease and type 2 diabetes and face an increasing
incidence of myocardial infarction (MI). Many conditions delay timely admi
nistration of thrombolysis, including long times between when patients firs
t experience symptoms and when they present to community nursing stations,
delays in air transfers to treating hospitals, uncertainty about when plane
s are available, and poor flying conditions.
OBJECTIVE OF PROGRAM To develop a program for administration of thrombolysi
s on the way to hospital by air ambulance paramedics flying to remote commu
nities to provide more rapid thrombolytic therapy to northern patients expe
riencing acute MIs.
COMPONENTS OF PROGRAM Critical care flight paramedics fly to northern commu
nities from Sioux Lookout, Ont; assess patients; communicate with base hosp
ital physicians; review an exclusion criteria checklist; and administer thr
ombolytics according to the Sioux Lookout District Health Centre/Base Hospi
tal Policy and Procedure Manual. Patients are then flown to hospitals in Si
oux Lookout; Winnipeg, Man; or Thunder Bay, Ont.
CONCLUSION This thrombolysis program is being pilot tested, and further eva
luation and development is anticipated.