TNKase

[rohit76]

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Is prolonged CPR considered as contraindication for thrombolytics?
I had a patient who came in with chest pain; first EKG normal. After 15 min, coded with episodes of VTach and V fib. 2nd EKG after the code showed new LBBB.Patient did require 15 min of chest compression. Cardiologist in hospital 45 min away advised no thrombolytics and prompt transfer which I complied with. I am not sure whether I followed 90 min window for stenting.

 

[Dimoak]

"The 2005 ERC guidelines on CPR recommend, that ongoing CPR should not be considered as a contraindication for a thrombolytic therapy."
European Resuscitation Council Guidelines 2005 for Resuscitation. Section 4. Advanced cardiac life support. Resuscitation 2005; 67S1: 39-86 (s)


However, it seems the jury's still out, because some sites still contraindicate it due to hemorrhage concerns. One note I've read I think contraindicated in cases of >5 minutes of CPR in past 2 weeks.

Hopefully that helps somewhat. 🙂

 

[Apollyon]

"The 2005 ERC guidelines on CPR recommend, that ongoing CPR should not be considered as a contraindication for a thrombolytic therapy."
European Resuscitation Council Guidelines 2005 for Resuscitation. Section 4. Advanced cardiac life support. Resuscitation 2005; 67S1: 39-86 (s)


However, it seems the jury's still out, because some sites still contraindicate it due to hemorrhage concerns. One note I've read I think contraindicated in cases of >5 minutes of CPR in past 2 weeks.

Hopefully that helps somewhat. 🙂

I thought it was >10 minutes. Oh well. Thank heavens for the cath lab!

 

[southerndoc]

I also thought it was 10 minutes, but there was always a clause for "traumatic CPR." In other words, if you felt like you broke a few ribs, then I wouldn't give thrombolytics.

As long as the patient could be in the cath lab within 90 minutes that's acceptable in my opinion.