American heart journal
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American heart journal · Dec 2006
Controlled Clinical TrialFeasibility and applicability of paramedic-based prehospital fibrinolysis in a large North American center.
Although considered the highest level of evidence and critical-to-test novel therapies, clinical trials are unrepresentative of the "real world" as they lack a true patient denominator, which limits general applicability of results. Accordingly, in conjunction with the Assessment of the Safety and Efficacy of a New Thrombolytic Regimen 3+ trial, we evaluated a comprehensive contemporary cohort of patients with ST segment elevation myocardial infarction (STEMI) to investigate: feasibility, applicability, safety, and efficacy of de novo paramedic-based prehospital fibrinolysis (PHF) program. ⋯ Feasibility and applicability of PHF was demonstrated with a substantial reduction in treatment delay and favorable clinical outcomes. Extending the unrealized potential of paramedic-based PHF programs in North America is feasible and desirable.