Reduction of pre hospital, ambulance, and hospital coronary death by the pre hospital emergency cardiac care system: a rationale for training emergency medical technicians, nurses, and physicians

During 3 yr of community wide hospital cardiopulmonary resuscitation and prehospital emergency cardiac care, prehospital coronary death rate fell 26% and ambulance coronary death rate 62%. When prehospital cardiopulmonary resuscitation, precordial thumbversion, and cardiac defibrillation began less than 5 min after cardiac arrest from acute myocardial infarction, 60% of patients under 70 yr of age resumed active life. Hospital mortality for patients with acute myocardial infarction managed in the prehospital phase was significantly lowered to 8.8%, and only 5% had cardiogenic shock. The practice of prehospital emergency cardiac care saved at least 5.8 lives per 100,000 population yearly. In conclusion, the training and involvement of emergency medical technicians, nurses, and physicians in prehospital cardiopulmonary resuscitation and prehospital emergency cardiac care seems a practical way to prevent prehospital coronary deaths and to reduce ambulance and hospital mortality from coronary disease.