• Eur J Emerg Med · Oct 2006

    Review

    Prehospital evaluation and treatment of a presumed acute coronary syndrome: what are the options?

    • Johan Herlitz and Leif Svensson.
    • Division of Cardiology, Sahlgrenska University Hospital, Göteborg, Sweden. johan.herlitz@hjl.gu.se
    • Eur J Emerg Med. 2006 Oct 1; 13 (5): 308-12.

    AbstractThe earlier infarct-limiting therapy is started the better is the outcome among patients suffering from a threatened myocardial infarction. The introduction of a prehospital electrocardiogram has improved triage of patients with acute chest pain. With regard to medication, fibrinolytic agents have the best documentation. Their use when frequently followed by a percutaneous coronary intervention at a later stage may be a good alternative among patients with ST-elevation myocardial infarction. Other treatments of potential value in the prehospital setting are oxygen, narcotic analgesics, nitrates, aspirin, heparin, low molecular weight heparin, glycoprotein IIB, IIIA blockers, clopidogrel and beta-blockers. We need further studies, however, for most of these treatments including cost-benefit analysis, analysis of various logistic aspects and safety in order to confirm their value.

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