nik azlan nik muhamad Muhamad Syis Zulkipli


Introduction: Knowledge on thrombolytic therapy and detection of ST elevation myocardial infarction (STEMI) is paramount among paramedics in order to initiate pre-hospital thrombolysis and pre-hospital activation of cardiac catheterization lab. This will eventually reduce door to needle and door to balloon time.1 This study is to  assess level of knowledge on prehospital thrombolytic therapy and ECG detection of STEMI among paramedics from UKM Medical Center (UKMMC) and Kuala Lumpur Hospital (HKL)


Methods: This descriptive study was conducted from May 2016 to November 2017. One hundred and six questionnaires were answered and analyzed. The questionnaire consists of 3 sections, each section has 10 questions. The first section was testing ECG detection of STEMI, second is a Likert scale on confidence in performing pre-hospital thrombolysis and the third is on knowledge of thrombolytic therapy.


Results: More than 60% of candidates were still unable to detect STEMI ECG changes and lacked of confidence in handling and administering thrombolytic treatment at the level of pre-hospital phase. Only 20.8% candidates managed to detect more than 8/10 of correct ECG pattern of STEMI.  Less than 40% of the candidates achieved more than 80% marks in answering questions regarding STEMI and treatment.


Discussion and conclusion:  It is concluded that overall performance and knowledge of paramedic regarding pre-hospital thrombolytic therapy is generally poor. Further training need to be done prior to implementing pre-hospital STEMI thrombolytic therapy in Malaysia




STEMI, prehospital, thrombolytic therapy, ECG

1. Effect of prehospital cardiac catheterization lab activation on door-to-balloon time, mortality, and false-positive activation, Squire BT, Tamayo-Sarver JH, Rashi P, Koenig W, Niemann JTPrehosp Emerg Care. 2014 Jan-Mar;18(1):1-8.
EMAS Meeting 2018 Abtracts