Prehospital Care of Acute Myocardial Lnfarction and Sudden Cardiac Death

The mortality rate of acute myocardial infarction (AMI) and sudden cardiac death can be reduced by establishing a well organized Emergency Medical Services (EMS) system. In Ilan country, the operation of the EMS system started in July 1991. In order to evaluate the function of the system, we reviewed 30 cases of AMI and 21 cases of sudden cardiac death admitted to Loton Po-Ai hospital from Aug 1, 1991 to Dec 31, 1992. Some problems seem to exist in the EMS system and are worth discussion. (1) 21 ﹪ of the patients didn't know how to get acess to the system. (2) The average response time was 4 minutes, however, the transportation time was 18 minutes. The mortality may be reduced only if the paramedics perform ALS care while travelling en route to the hospital. (3) 50﹪ of the AMI patients were transfered from other hospitals and none received ECG monitoring during transportation. This is very dangerous and we suggest that the EMS system should include the interhospital transfer of unstable and potentially unstable patients.#C2293060