Publications

1. Recognition of eligibility for thrombolysis by paramedics (based on clinical features and the ECG). No transmission of data but the A/E department or CCU will be alerted.
2. As above (Model 1), but in addition with transmission of clinical information and the ECG so that the hospital has all relevant details for clinical decision before patient's arrival.
3. As above (Model 2), but with direct contact with a physician who might then authorise the prehospital administration of a thrombolytic drug on a named patient basis.
4. Co-operation in rural areas with primary care physicians who will administer the agents in the patient's home, within the ambulance, or in local community hospitals before transfer to a DGH.
5. Administration of thrombolytics by trained paramedics acting autonomously, either using streptokinase (available under the PMO arrangements) or reteplase using Patient Group Directions.