[Prehospital thrombolytic therapy of myocardial infarction in Northern Norway. How to improve the service for patients in sparsely-populated areas?].

: Up to now, thrombolytic treatment in myocardial infarction has been restricted to coronary care departments in Norwegian hospitals. Owing to the highly significant impact of the time elapsing between onset of symptoms and thrombolytic treatment, it has been a challenge to offer patients in remote areas early treatment. The rescue helicopter in Northern Norway is manned by an anaesthesiologist. By taking advantage of this, in combination with strict diagnostic criteria, prehospital treatment with streptokinase is now offered in addition to pain relief, oxygen, nitrates and aspirin, and observation against arrhythmia. By these means, patients in remote areas can receive thrombolytic treatment without the delay caused by transportation and in-hospital examination, and a high level of safety is maintained. It still remains, however, to shorten the patients' and the doctors' delay in notifying the helicopter. It is suggested, that all anaesthesiologist-manned air ambulances implement this technique after consulting local general practitioners and cardiologists.