Thrombolysis in the pre-hospital setting

Pre-hospital thrombolysis has proven clinical benefits in the management of acute myocardial infarction (MI). If the targets for administering thrombolysis, in particular call-to-needle time, are to be met, then it seems likely that its use will be more widespread. With appropriate training and support, paramedics can competently perform 12-lead electrocardiograms (ECGs) and administer thrombolysis. Cardiologists should be prepared to undertake paramedic training and play a central role in the development of protocols and pathways for the administration of pre-hospital thrombolytic therapy.