Senior staff should see all emergencies

doi:10.1136/bmj.308.6937.1159b

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James Stevenson

Senior registrar, Accident and Emergency Department, Newcastle General Hospital, Newcastle upon Tyne NE4 6BE.

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 …