Abstract
Time intervals between the onset of the presenting symptom (chest pain) and arrival in a coronary care unit were studied for 221 admissions arranged by conventional means. The median figure for “patient delay” was 60 minutes, for “general-practitioner delay” 20 minutes, for “ambulance delay” 30 minutes, and for “transit delay” 30 minutes. The median “total delay” was three hours 30 minutes.
Only 4·5 per cent of the patients were under intensive coronary care within one hour, the time of the highest mortality risk. A mobile coronary service should be capable of increasing the proportion of patients brought under special care within the first hour, but the time taken by the patient to realise the nature of the emergency and summon aid is likely to remain the most critical factor.
Full text
PDF
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Armstrong A., Duncan B., Oliver M. F., Julian D. G., Donald K. W., Fulton M., Lutz W., Morrison S. L. Natural history of acute coronary heart attacks. A community study. Br Heart J. 1972 Jan;34(1):67–80. doi: 10.1136/hrt.34.1.67. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Gilchrist I. C. Factors affecting admission to a coronary care unit. Br Med J. 1971 Oct 16;4(5780):153–156. doi: 10.1136/bmj.4.5780.153. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Gilchrist I. C. Patient delay before treatment of myocardial infarction. Br Med J. 1973 Mar 3;1(5852):535–537. doi: 10.1136/bmj.1.5852.535. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Hackett T. P., Cassem N. H. Factors contributing to delay in responding to the signs and symptoms of acute myocardial infarction. Am J Cardiol. 1969 Nov;24(5):651–658. doi: 10.1016/0002-9149(69)90452-4. [DOI] [PubMed] [Google Scholar]
- Kernohan R. J., McGucken R. B. Mobile intensive care in myocardial infarction. Br Med J. 1968 Jul 20;3(5611):178–180. doi: 10.1136/bmj.3.5611.178. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Lawrie D. M., Greenwood T. W., Goddard M., Harvey A. C., Donald K. W., Julian D. G., Oliver M. F. A coronary-care unit in the routine management of acute myocardial infarction. Lancet. 1967 Jul 15;2(7507):109–114. doi: 10.1016/s0140-6736(67)92959-5. [DOI] [PubMed] [Google Scholar]
- McNeilly R. H., Pemberton J. Duration of last attack in 998 fatal cases of coronary artery disease and its relation to possible cardiac resuscitation. Br Med J. 1968 Jul 20;3(5611):139–142. doi: 10.1136/bmj.3.5611.139. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Moss A. J., Goldstein S. The pre-hospital phase of acute myocadial infarction. Circulation. 1970 May;41(5):737–742. doi: 10.1161/01.cir.41.5.737. [DOI] [PubMed] [Google Scholar]
- Pantridge J. F., Geddes J. S. A mobile intensive-care unit in the management of myocardial infarction. Lancet. 1967 Aug 5;2(7510):271–273. doi: 10.1016/s0140-6736(67)90110-9. [DOI] [PubMed] [Google Scholar]
- Restieaux N., Bray C., Bullard H., Murray M., Robinson J., Brigden W., McDonald L. 150 Patients with cardiac infarction treated in a coronary unit. Lancet. 1967 Jun 17;1(7503):1285–1289. doi: 10.1016/s0140-6736(67)91589-9. [DOI] [PubMed] [Google Scholar]
- Shaw G., Groden B., Hastings E. Coronary care in a General Hospital. Results and observations on the first year's work in the unit in the Southern General Hospital, Glasgow. Scott Med J. 1971 Mar;16(3):173–182. doi: 10.1177/003693307101600302. [DOI] [PubMed] [Google Scholar]
- Walsh M. J., Shivalingappa G., Scaria K., Morrison C., Kumar B., Farnan C., Chaturvedi N. C., Boyle D. M., Barber J. M. Mobile coronary care. Br Heart J. 1972 Jul;34(7):701–704. doi: 10.1136/hrt.34.7.701. [DOI] [PMC free article] [PubMed] [Google Scholar]