Guidelines for the prehospital use of thrombolytic agents

Recognizing that prehospital thrombolytic therapy may provide benefit to certain subsets of patients, the routine prehospital use of thrombolytic agents should be discouraged pending further scientific delineation and documentation of those subgroups. ACEP encourages further investigation to document feasibility, efficacy, cost-effectiveness, and safety of use of these agents in this environment. Detailed education is needed in such areas as contraindications and the mechanics of drug administration. Online medical direction is paramount to the successful use of these agents in the prehospital setting.