VHAC Lytic Algorithm Tool

The VHAC Lytic Algorithm is a standardized, evidence-based clinical decision support tool designed to guide the rapid evaluation and treatment of patients presenting with ST-elevation myocardial infarction (STEMI) when timely access to PCI is not available.
This algorithm supports emergency departments and EMS teams in identifying STEMI, assessing thrombolytic eligibility, and making time-critical decisions regarding thrombolytic administration versus direct transport to a PCI-capable center. It emphasizes early ECG acquisition and interpretation, strict treatment time benchmarks, and structured communication with receiving facilities to reduce delays and improve patient outcomes.
Key features of the tool include:
Clear STEMI identification and activation workflow
Defined absolute and relative contraindications to thrombolytic therapy
Transport decision guidance when PCI access is delayed
Standardized medication recommendations and dosing considerations
Required reassessment and repeat ECG timing
Communication checkpoints with receiving PCI centers
This tool was developed by the VHAC Thrombolytics Workgroup and presented in October 2025, promoting regional consistency in care delivery and alignment with national best practices for STEMI management in time- and resource-limited settings.