PreHospital Cardiac Care

1
Pre-Hospital Cardiac Care

• 12 Lead Telemetry
• Pre- Hospital Thrombolysis
• Primary Angioplasty

Gerry Egan Dip IMC RCSed Scottish Ambulance
Service
2
Historical perspective (1980s 1994)

• Chest Pain
• Call GP/ 999
• GP review arrange admission (often 1 hour call)
• SAS transport to AE
• Treatment - O2, Aspirin, GTN, Analgesia?

3
Drivers for Change

• All SAS vehicles equipped with new Lifepak 12
  defibrillator technology, including 12 lead ECG
  module
• Paramedic staff trained in the acquisition,
  transmission and interpretation of 12 lead ECGs
• Telemetry receiving station installed CCU at RIE

4
2004 onwards

• Chest Pain
• Call GP / 999 / NHS 24
• GP review arrange admission? (1hour?)
• Treatment O2, Aspirin, GTN, Morphine, Anti
  Emetic, TNK,
• 12 lead telemetry to CCU- Decision Support
• Admission CCU- AE- ARU

5
Implementation

• 12 SAS vehicles in East/Mid-Lothian equipped with
  Tenecteplase
• 1st transmission received May 2004
• 1st patient receiving Tenecteplase 4 days into
  initiative

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Experiences to date
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Experiences to date
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Experiences to date
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Experiences to date

• Over 3500 transmissions in the 9 months between
  May 2004 to May 2005
• While now at complete coverage, average of 8.3
  transmissions per day
• Gross coverage of the 850,000 population of SE
  Scotland RIE, WGH, SJH, BGH,
  Misc.
• Now working at improving technology.

10
Future developments

• All 47 Lothian SAS vehicles equipped with TNK
  making the initiative the UKs biggest. Now
  rolling across Scotland.
• Extension of protocol to non-AMI Acute Coronary
  Syndrome patients
• Primary Angioplasty !

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Questions ?

• Thank You