Br Med J 1978;1:1118-1121 (29 April), doi:10.1136/bmj.1.6120.1118
Randomised trial of a mobile coronary care unit for emergency calls.
A randomised trial was conducted to assess the value of sending
a mobile coronary care unit (MCCU) to all emergency calls other
than those for children or for patients injured in road-traffic
accidents or brawls. Over 15 months 6223 calls for emergency
ambulances were considered for the study, but a routine ambulance
had to be dispatched on 2583 occasions because the MCCU was
not available. A group of 1664 patients was randomly allocated
to transport by the MCCU and 1676 patients to routine transport.
In these groups the prehospital mortality among patients with
heart attacks was 45% and 47%, and no patient survived resuscitation
attempts long enough to leave hospital. During the same period
general practitioners sent 190 patients with heart attacks to
hospital in routine ambulances and none of them died during
the interval between the call for the ambulance and arrival
at hospital. Although it may be worth equipping all emergency
ambulances with a defibrillator, MCCUs as at present envisaged
will not appreciably affect mortality from heart attacks.

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[Abstract]