Implementing paramedic thrombolysis--an overview.

The UK Government has made improvements in cardiac care a high priority. The publication in 2000 of the National Service Framework for Coronary Heart Disease and the NHS Plan set out national standards for the management of suspected heart attack, including challenging targets for reducing treatment delays for administration of thrombolytic therapy. This paper discusses the background, evidence base and challenges of implementing one component of the Government's drive to improve cardiac care: the NHS Plan commitment to a three year programme to equip and train ambulance paramedics to safely provide thrombolysis for appropriate patients.