Missouri Code of State Regulations › Title 19 - DEPARTMENT OF HEALTH AND SENIOR SERVICES › Division 30 - Division of Regulation and Licensure › Chapter 40 - Comprehensive Emergency Medical Services Systems Regulations › Section 19 CSR 30-40.780 - Definitions and Abbreviations Relating to the Transport Protocol for Stroke and the Transport Protocol for ST-Segment Elevation Myocardial Infarction (STEMI) Patients

Current through Register Vol. 49, No. 14, July 15, 2024
PURPOSE: This rule defines terminology related to the
				  state transport protocol for stroke and the state transport protocol for
				  STEMI.
(1) The following
				definitions and abbreviations shall be used in the interpretation of the rule
				in
				19
				CSR 30-40.790:
(A)
				Field is the specific area or location, outside of the hospital, where an
				injury, accident, or medical emergency occurs requiring immediate assistance of
				medical personnel for the purpose of treating or transporting the sick or
				injured to another location for treatment;
(B) Local and regional process is the process
				that has been established and agreed upon specifically pertaining to a local
				city, town, or small district, or a combination of localities forming a
				regional area. This is not the community-based or regional plan;
(C) Lytics are thrombolytic drugs, including
				recombinant tissue plasminogen activator, used to dissolve clots blocking flow
				in a blood vessel. These lytic/thrombolytic drugs are used in the treatment of
				acute ischemic stroke and acute myocardial infarction;
(D) Lytic/therapeutic window is the period of
				time during which lytics can be administered following the onset of symptoms in
				order to reduce brain or heart injury;
(E) Lytic therapy
				(fibrinolysis/thromboly-sis) is drug therapy used to dissolve clots blocking
				flow in a blood vessel. It refers to drugs used for that purpose, including
				recombinant tissue plasminogen activator. This type of therapy can be used in
				the treatment of acute ischemic stroke and acute myocardial
				infarction;
(F) Lytic/thrombolytic
				ineligible patients are those patients identified as ineligible for
				lytic/thrombolytic therapy due to specific contraindications. An appropriate
				course of treatment will be utilized when lytic/thrombolytic therapy is
				contraindicated;
(G) Out of the
				lytic/therapeutic or potential therapeutic window is the period of time
				following the accepted time (lytic/therapeutic window and potential therapeutic
				window) frames for specific therapies for a patient suffering an ischemic
				stroke;
(H) Outside of the
				percutaneous coronary intervention (PCI) window is the period of time following
				the accepted time frame in which PCI is most advantageous and
				recommended;
(I) Percutaneous
				coronary intervention (PCI) is a procedure used to open or widen narrowed or
				blocked blood vessels to restore blood flow supplying the heart;
(J) Percutaneous coronary intervention (PCI)
				window is a time frame in which PCI is most advantageous and
				recommended;
(K) Potential
				therapeutic window is the period of time after the accepted window for lytic
				therapy has expired in which interventional therapy may be beneficial in
				restoring blood flow during an ischemic stroke; and
(L) Recombinant tissue plasminogen activator
				(t-PA also known as rt-PA) is a thrombolytic (clot-dissolving) agent, the goal
				of which is to destroy the thrombus (clot) within the blood vessel by
				stimulating fibrinolysis (clot breakdown) to allow restoration of blood
				flow.