Early heart treatment can save lives
Wed 25 Jun 2008
Heart attack patients given early drug treatment by ambulance paramedics have a better chance of survival and fewer complications than those who wait until they get to hospital, a new study shows.
Blood clot dissolving drugs called thrombolytics are more effective if they are administered at the scene rather than by a hospital doctor, according to the research, funded by the Queensland Ambulance Service (QAS).
The data on almost 30,000 overseas patients with chest pain showed that thrombolytics could be administered almost an hour earlier if given by paramedics at the scene.
Simulation modelling also found that 10.5 per cent of deaths over the first 30 days after a heart attack could be averted and the risk of heart failure in those patients could be cut by up to 40 per cent.
QAS medical director Dr Stephen Rashford said Queensland was the first Australian state to adopt the practice on a state-wide basis.
Since February 18, around 40 patients have been given thrombolytic drugs such as tenecteplase by paramedics trained with ECG (electrocardiogram) skills to diagnose the type of heart attack called ST-elevated myocardial infarction.
"The drug is traditionally given by physicians and by having paramedics giving it, on average, we administer it about 30 minutes faster than has been done in the past," Dr Rashford said.
"Thirty minutes doesn't sound like much but the old adage is time is muscle and for every minute that the heart is deprived of oxygen, more muscle dies.
"By reopening those arteries as early as we can we actually hope to improve outcomes and that's what this study demonstrates should occur."
The study was headed by health economist Professor Paul Scuffham, of Brisbane's Griffith University School of Medicine, who found that the increased survival rates resulted in slightly higher health care costs for patients and their ongoing medical and surgical management.
But Prof Scuffham said the cost of having paramedics administering thrombolytic therapy was a sound investment in improving patients' health.
The study has been published online in Current Medical Research and Opinion.