Standards Procedure (Skill)

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Thrombolytic Screen

Clinical Indications:                                                               Levels: EMT-B, EMT- D,

                                                                                                             EMT-I, EMT-P

Ø      Rapid evaluation of a patient with suspected acute stroke, acute myocardial infarction, or acute pulmonary embolus who may benefit from thrombolysis

Procedure:

a.       Follow the appropriate protocol for the patient’s complaint to assess the need for thrombolytic therapy (e.g. LAPSS or other instrument for suspect stroke, 12 lead ECG for suspected myocardial infarction, etc.).  If the screen is positive proceed as described below.

b.      Through history from the patient and/or family members, obtain and record the following information:

v     History of active internal bleeding?

v     History of neoplasm, arteriovenous (AV) malformation, or CNS aneurysm?

v     History of CNS surgery in the past 2 months?

v     History of severe uncontrolled hypertension (>200/130)?

v      History of bleeding disorder?

v     History of aortic dissection?

v     History of allergy to tPA?

c.       Record all findings on the patient’s ACR and fill out a Thrombolitic Screening Form. Cardiac or CVA.

Certification Requirements:

Successfully complete an annual skill evaluation including the indications, contraindications, technique, and possible complications of the procedure.