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Life-saving link to ambulances

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Heart attack victims across Scotland could benefit from new equipment being installed in Dundee’s Ninewells Hospital later this week, writes Marjory Inglis, medical reporter. The equipment will connect every ambulance in the country to the hospital’s accident and emergency department, allowing paramedics to transmit heart traces from patients to consultants in A&E, who can then pass on advice. The link offers paramedics support from doctors when a decision is required on whether or not a patient is suitable to receive clot-busting drugs.

Paramedic delivery of clot-busting drugs is being rolled out across Scotland following a successful pilot in Angus where local paramedics were the first in the country to give patients the drugs at the scene of an attack. A subsequent study by Ninewells-based Dr Mike Jones concluded the Angus paramedics were saving lives delivering clot-busting drugs.

Today it emerged that patients in rural Perthshire will have their chances of survival boosted when paramedics begin delivering clot-busting drugs later this week as part of the Scotland wide roll-out.

“The Angus pilot has been a tremendous success,” said Paul Kelly, the Scottish Ambulance Service’s area manager for A&E services in Perth and Perthshire.

“All A&E ambulances in Perth and Perthshire will be carrying clot-busting drugs from later this week. We are trying to make sure rural locations in particular have this drug available for patients who will have a distance to travel to hospital.

“Coronary heart disease is one of the big killers in Scotland. We are trying to tackle that by reducing what we call the pain-to-needle time.”

He explained that by reducing the time it took between a heart attack victim experiencing pain and receiving clot-busting drugs, paramedics could reduce the damage to the heart muscle and ensure a better outcome for the patient. The patient would have an “improved recovery” and spend less time in hospital.

Reluctant to “sensationalise” the work of paramedics, Mr Kelly conceded, “There would be people who have, in the past, died in the community that could have been saved, but these drugs were unavailable (until recently for delivery by paramedics).”

Dr Jones’ study of the pilot, published in the British Medical Journal, concluded clot-busting drugs delivered by paramedics in Angus were saving lives.

Mr Kelly said new equipment was going in to Ninewells to allow doctors in A&E to receive ECGs (recordings of a patients’ heart activity) from every ambulance in Tayside. It was a replacement for an existing link between Ninewells and the Angus paramedics and would allow consultation on the more complex cases. He said paramedics were already making decisions about the delivery of clot-busting drugs to “obvious cases”.

Consultant Neil Nichol, clinical leader of A&E, said the new equipment would, in theory, allow consultants in his team to give advice to paramedics across Scotland.

“Our normal patch will be Tayside, North East Fife and Forth Valley,” said Mr Nichol. “The system the Scottish Ambulance Service is putting in is the same as the one they are putting in to other big hospitals in Scotland and each one covers their own particular patch. But if there is a problem getting through to a local hospital, we could well have to stand in for Glasgow or wherever. We will have that back-up capacity.

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