Monitoring of the quality of thrombolytic therapy in case of acute coronary syndrome at pre-hospital stage


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Abstract

The purpose of the study is to assess the quality of thrombolytic therapy (TLT) in acute coronary syndrome with ST-segment elevation (OCCPST) at prehospital stage over 5 years dynamics. Material and methods. A retrospective study of patients with acute coronary syndrome with ST-segment elevation who applied for emergency medical care (SMP) at the ambulance station municipal budgetary institution of Yekaterinburg and received TLT with tenecteplase medicine at pre-hospital stage during 2013-2017 was made. Study group included 753 persons, the average age of patients was 57.3 ± 11.8 years. All acute coronary syndrome patients with ST-segment elevation were hospitalized in specialized hospitals with round-clock possibility of invasive treatment methods, each patient got medical aid according to the existing standards of the emergency medical system, clinical protocols and the professional standard "Ambulance physician". The quality of prehospital TLT was determined by a patented method that includes a complex estimation of such indexes as rationality, effectiveness, safety, timeliness of therapy, legal correctness of filling in documentation, accessibility, qualifications of medical personnel and patient satisfaction. Results. All indicators of TLT in case of acute coronary syndrome at pre-hospital stage have improved over the years of observation, due to the accumulated experience of the ambulance doctors and educational activities, as well as due to the appearance of emergence standards and clinical protocols (recommendations) for providing the emergency medical care to the population. Conclusion. The proposed by the authors indicators of prehospital TLT quality in case of acute coronary syndrome with ST-segment elevation can be taken as a basis for estimation the prehospital thrombolysis quality by an expert of any level.

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About the authors

Dilyara F. Khusainova

Ural state medical university

Email: husainovad@mail.ru
PhD, associate professor of the Department of hospital therapy and emergency medical aid

Igor V. Kholkin

Municipal budgetary institution V.F. Kapinos ambulance station

Email: Igor-kholkin@mail.ru
head of the Department of anaesthesiology and rheanimatology No. 1

Lyudmila A. Sokolova

Ural state medical university

Email: lasokolova48@mail.ru
MD, head of the Department of hospital therapy and emergency medical aid

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