Paramedics in Saskatchewan and Alberta will soon be administering the clot- busting drug tenecteplase (TNK) to heart attack patients in the field. The move is part of a 1-year clinical trial. The trial, involving paramedics in Edmonton, 2 Alberta counties and Saskatoon, will assess whether patients who receive thrombolytic drugs before arriving at hospital have better outcomes. Paramedics will connect suspected heart attack patients to a 12-lead ECG and transmit the results to participating hospitals. Physicians staffing a 24-hour hotline will deliver the diagnosis and may give a verbal order to inject TNK at once. “When it comes to heart attacks, time is muscle,” said Tim Hillier, director of education for Saskatoon's MD Ambulance. “The shorter the time from onset of pain to receipt of these drugs, the less damage is done, which in turn improves a patient's chances of recovery. Within the city we should be able to save 10 to 15 minutes.”
Studies have shown that TNK is as effective as tissue plasminogen activator (tPA) but is easier to administer. It requires a single injection rather than tPA's 90-minute, 3-bolus infusion. Patients will also receive 1 of 2 different anticoagulant drugs as part of the trial, which began this fall. —
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Greg Basky
Saskatoon