Prehospital thrombolysis perfomed by a ship's nurse with on-line physician consultation
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Updated: Aug 19, 2026

Prehospital Thrombolysis: A Manual from Berlin
Published on: November 26, 2013
Olli Väisänen1, Markku Mäkijärvi, Tom Silfvast
1Arcada Polytechnic, Toukolanite 1, 00550 Helsinki, Finland. olli.vaisanen@arcada.fi
Prehospital thrombolysis for acute ST-elevation myocardial infarction (STEMI) has been shown to improve recovery from myocardial function. We describe prehospital thrombolytic treatment in two patients suffering from STEMI complicated by ventricular fibrillation (VF) on a passenger ship. The importance of a functioning Emergency Medical Service (EMS) system providing guidance for paramedical personnel is discussed briefly. Both our patients survived and returned back to normal life. It is concluded that EMS physician guided prehospital thrombolytic treatment may offer an important therapeutic option for nurses or paramedics in locations out of reach of ordinary EMS services.
Prehospital thrombolysis for acute ST-elevation myocardial infarction (STEMI) has been shown to improve recovery from myocardial function. We describe prehospital thrombolytic treatment in two patients suffering from STEMI complicated by ventricular fibrillation (VF) on a passenger ship. The importance of a functioning Emergency Medical Service (EMS) system providing guidance for paramedical personnel is discussed briefly. Both our patients survived and returned back to normal life. It is concluded that EMS physician guided prehospital thrombolytic treatment may offer an important therapeutic option for nurses or paramedics in locations out of reach of ordinary EMS services.
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