BMJ 1994;308:1159 (30 April)

Letters

Senior staff should see all emergencies

EDITOR,--The guidelines for the early management of patients with myocardial infarction raise several points and highlight some deficiencies in the care of emergencies in Britain.1 It is important to differentiate between treatment required by patients who present with cardiac arrest and that required by patients who present with symptoms of chest pain suggestive of myocardial infarction.

The best chance of survival after cardiac arrest in the community occurs when a bystander gives immediate and effective basic life support and this is followed by early advanced cardiopulmonary resuscitation and then evacuation to hospital.2 Advanced resuscitation is currently most readily provided by paramedics working independently.

On the other hand, if a patient has chest pain suggestive of myocardial infarction a response by both the general practitioner and the ambulance service seems ideal. This combines the diagnostic and treatment skills of the general practitioner with the equipment and rapid, safe route to hospital . . . [Full text of this article]


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Relevant Article

Guidelines for the early management of patients with myocardial infarction
C F M Weston, W J Penny, and D G Julian
BMJ 1994 308: 767-771. [Extract] [Full Text]

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