Prehospital thrombolysis in myocardial infarction

Studies comparing paramedic-initiated and hospital-initiated therapy show that the critical issue is not where or by whom thrombolysis is started but when it is started. Two of the greatest time-savers--and hence modifiers of infarct size and mortality--have been the introduction of the computer-interpreted ECG and simply alerting the hospital that a patient with a diagnosed acute MI will be arriving shortly.