If PCI is not available, within how many minutes should fibrinolysis be administered after first medical contact?

• A. Within 120 minutes after first medical contact for fibrinolysis if PCI unavailable.
• B. Within 24 hours.
• C. Within 60 minutes regardless of PCI.
• D. Immediately before any assessment.

Answer: (A)

Timely reperfusion is crucial when PCI isn’t available. If a primary PCI center can’t treat the patient within a reasonable time, fibrinolysis should be given as soon as possible, ideally within 120 minutes from first medical contact. This window reflects the balance between giving reperfusion early enough to salvage heart muscle and ensuring patient safety by evaluating eligibility and contraindications. Waiting much longer—like 24 hours—loses much of the benefit, and aiming for only 60 minutes from the moment care is first sought can be impractical across EMS and varied hospital settings. Administering fibrinolysis before any assessment would ignore safety checks and eligibility criteria. Therefore, the recommended target is to administer fibrinolysis within 120 minutes of first medical contact when PCI isn’t available.