Abstract

Timely thrombolytic therapy is vital for acute ischemic stroke and STEMI, as delays increase tissue damage, worsen recovery, and raise mortality. A 24×7 thrombolysis service within the Emergency Department can reduce door-to-needle times, improve access in resource-limited settings, and enhance outcomes. This review highlights the rationale, epidemiology, clinical evidence, infrastructure, training, implementation, cost-effectiveness, barriers, and future directions. A model for Uttar Pradesh is proposed, focusing on ED integration, task-sharing, point-of-care diagnostics, a “one-room unit,” and robust monitoring, governance, and research linkages, tailored to the Indian context.

Keywords

Acute Myocardial Infarction, Emergency Medicine, Ischemic Stroke, Point- of-Care Testing, Thrombolysis Service, Universal Health Coverage