When is prehospital fibrinolytic therapy indicated for myocardial infarction (MI, heart attack), and what is its availability?

Updated: May 07, 2019
  • Author: A Maziar Zafari, MD, PhD, FACC, FAHA; Chief Editor: Eric H Yang, MD  more...
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Prehospital fibrinolytic therapy by the administration of tissue-type plasminogen activator (t-PA), aspirin, and heparin may be given to patients with bona fide MI by paramedics, as guided by electrocardiographic findings, within 90 minutes of the onset of symptoms. This treatment improves outcomes, as compared with thrombolysis begun after the patient arrives at the hospital. Prehospital fibrinolytic therapy is not used widely in the United States due to the lack of resources to train EMS personnel or the lack of funding for necessary equipment. However, it is more widespread in some regions in Europe and the United Kingdom.

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