PATCAR Study Inclusion and Exclusion Criteria

Bonus content to 'Prehospital Fibrinolysis in Concert with Rapid PCI'


 
 

David E. Persse, MD, FACEPJames J. McCarthy, MD, FACEPMary Vooletich, RN, BSNBonnie K. Richter, BS, EMT-PH. Vernon Anderson, MD, FACCAli E. Denktas, MD, FACCStefano M. Sdringola, MD, FACCRichard W. Smalling, MD, PhD, FACC | From the January 2008 Issue | Saturday, July 26, 2008


As discussed in"Prehospital Fibrinolysis in Concert with Rapid PCI" inMarch 2008 JEMS, acute myocardial infarction (AMI) remains a leading cause of death in the U.S. despite the many recent advances in cardiac care. Re-establishing blood flow through the infarct-related coronary artery using lytic agents or balloon angioplasty with or without stent placement, also known as percutaneous coronary intervention (PCI), as early as possible, has been the main focus of STEMI care.

But there's controversy over which therapy is superior -- IV lytic therapy that could be administered quickly in the emergency department, or PCI, which would take longer but potentially be more definitive and theoretically have less associated risk of hemorrhage.

In an effort to contribute to knowledge that could resolve this controversy, Houston Fire Department (HFD) EMS began a pilot study on reduced-dose prehospital fibrinolysis used with urgent PCI to assess the effects on STEMI patients. The pilot study is known as PATCAR (Prehospital Administration of Thrombolytic Therapy with Urgent Culprit Artery Revascularization) and was undertaken through a partnership with the University of Texas Health Science Center at Houston Medical School and the university's teaching institution, Memorial Hermann Hospital.

One of the initial purposes of this pilot trial is to demonstrate the feasibility of urban paramedics to accurately and safely identify fibrinolytic-eligible STEMI patients and initiate therapy appropriately.

When an HFD paramedic arrives on scene and identifies a patient as experiencing a STEMI and a potential candidate for the administration of a fibrinolytic, the paramedic reviews the HFD Acute Myocardial Infarction Therapy Inclusion and Exclusion Criteria and enrolls the patient into the program. (Download the PDF at the bottom of the page to review the criteria.)

Four STEMI patient groups are being evaluated:

  • Group A: Full-dose, prehospital initiated fibrinolysis (given half-dose in the ambulance and half-dose 30 minutes later) followed by treatment in the coronary-care unit;
  • Group B: Half-dose prehospital fibrinolysis followed by urgent PCI;
  • Group C: Patients who are ineligible for fibrinolysis; and
  • Group D: Patients not transported by participating EMS units.
To read about the preliminary results of this pilot study,check out the March 2008 issue of JEMS.


Connect: Have a thought or feedback about this? Add your comment now
Related Topics: Patient Care, Cardiac and Circulation, Research, Jems Features

What's Your Take? Comment Now ...

Featured Careers & Jobs in EMS





 

Get JEMS in Your Inbox

 

Fire EMS Blogs


Blogger Browser

Today's Featured Posts

 

EMS Airway Clinic

Innovation & Progress

Follow in the footsteps of these inspirational leaders of EMS.
More >

Multimedia Thumb

Community Paramedicine Expanding in Maine

Eight departments receive a grant for use towards the new program.
Watch It >


Multimedia Thumb

New Ambulance, Fire Engine Approved for Illinois Department

Officials approve new purchases for Bloomington.
Watch It >


Multimedia Thumb

Alabama Officials Worry over Ambulance Coverage

County officials work to find best solution.
Watch It >


Multimedia Thumb

Car Crashes into Texas Ambulance

Ambulance hit while responding to a call.
Watch It >


Multimedia Thumb

San Diego Fire-Rescue Responds to Plane Crash

Small plane crashes in shopping center parking lot.
More >


Multimedia Thumb

California Beach Lightning Strike MCI

More than a dozen injured in Venice Beach lighting strike.
More >


Multimedia Thumb

Braun Ambulances' EZ Door Forward

Helps to create a safer ambulance module.
Watch It >


Multimedia Thumb

VividTrac offered by Vivid Medical - EMS Today 2013

VividTrac, affordable high performance video intubation device.
Watch It >


Multimedia Thumb

The AmbuBus®, Bus Stretcher Conversion Kit - EMS Today 2013

AmbuBus®, Bus Stretcher all-hazards preparedness & response tool
Watch It >


More Product Videos >