Related Experiment Video
Updated: Jul 5, 2025
05:52
Prehospital Thrombolysis: A Manual from Berlin
Published on: November 26, 2013
21.9K
Informing Utstein-style reporting guidelines for prehospital thrombolysis: A scoping review
Louis Jenkins1, Tania Johnston2, Richard Armour3
1Faculty of Science and Health, School of Nursing, Paramedicine and Healthcare Sciences, Charles Sturt University, Bathurst, New South Wales, Australia.
Australasian Emergency Care
|January 17, 2024
Summary
Paramedic-administered prehospital thrombolysis (PHT) improves care for rural Australians with acute myocardial infarction (AMI). Standardized quality indicators are needed to guide PHT practices and improve patient outcomes.
Area of Science:
- Cardiology
- Emergency Medicine
- Health Services Research
Background:
- Rural Australians with acute myocardial infarction (AMI) experience higher mortality rates due to limited access to specialized cardiac services.
- Prehospital thrombolysis (PHT) administered by paramedics is a crucial alternative for AMI patients facing delays in accessing primary percutaneous intervention (pPCI).
- Current PHT practices in Australia lack standardization in definitions and outcome measures, necessitating a review of quality indicators.
Purpose of the Study:
- To conduct a scoping review to identify quality indicators for paramedic-administered prehospital thrombolysis (PHT).
- To identify factors influencing patient outcomes in prehospital thrombolysis for acute myocardial infarction (AMI).
- To inform the development of standardized reporting guidelines for PHT.
Main Methods:
- Systematic literature search of SCOPUS, Academic Search Complete, CINAHL, and Health Source databases.
- Screening of peer-reviewed studies from the past decade focusing on prehospital thrombolysis and quality indicators.
- Data extraction and thematic analysis using the Utstein-style template domains.
Main Results:
- 28 empirical studies met inclusion criteria from an initial search of 3596 articles.
- Identified 24 clinical quality indicators and influencing factors across EMS systems, AMI recognition, patient variables, and PHT processes.
- Findings align with the Donabedian structure-process-outcome model, offering utility for future PHT reporting.
Conclusions:
- Standardized reporting on PHT quality indicators is essential due to practice variability among Australian ambulance services.
- The Utstein-style template can be adapted for quality improvement in PHT, similar to its use in cardiac arrest reporting.
- The identified 24 quality indicators can guide future Delphi studies and the development of an Utstein-like reporting guideline for PHT.
