Role of emergency medical services

Article Abstract:

Acute myocardial infarction (AMI), blockage of blood vessels in the heart (heart attack), is treated with drugs called thrombolytic agents. These drugs dissolve blood clots, opening clogged blood vessels so normal blood flow can be restored. Thrombolytics have been proven to be effective in reducing morbidity and mortality, but for these drugs to be effective, they must be administered shortly after the onset of myocardial infarction. Delays in seeking medical attention and delays in transport to the hospital consume valuable time. Emergency medical services can reduce the time delay before treatment is started. Emergency medical services may be public or private and the training of personnel ranges from first aid to advanced life support. The most common service is the basic ambulance service that provides transportation and fist aid, including cardiopulmonary resuscitation (CPR). Mobile intensive care units provide the most advance level of service and are staffed with paramedics that can administer drugs and perform life-saving procedures on the way to the hospital. Improving the quality of prehospital medical care would ensure that patients receive rapid and efficient medical attention. A national emergency number, which can rapidly identify the calling number and street address, should be used in each state. Dispatchers require medical training so that they can give instructions while the patient waits for emergency medical services to arrive. Ambulances should be strategically located to provide the fastest service possible. All emergency medical technicians in ambulances should be able to use defibrillators to treat cardiac arrest. (Consumer Summary produced by Reliance Medical Information, Inc.)

Training, Emergency medical services, Emergency medical personnel

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Problems faced by the urban emergency department in providing rapid triage and intervention for the patient with suspected acute myocardial infarction

Article Abstract:

It is estimated that more than 1 million Americans each year experience a heart attack, acute myocardial infarction (AMI). An AMI occurs when blood vessels in the heart become blocked, which reduces the amount of blood and oxygen delivered to the heart muscle. Drugs called thrombolytic agents are effective in dissolving blood clots, reopening clogged blood vessels, and reducing patient mortality. However, these drugs must be administered very soon after the onset of AMI if they are to be effective. The sooner treatment is started, the better is the chance of survival and recovery. It is recommended that patients with AMI receive treatment with thrombolytic agents within the first hour after arrival at the hospital emergency department. However, only 14 percent of the patients who come to the emergency room with symptoms of chest pain actually have AMI, and only one-quarter to one-third of these patients require thrombolytic therapy. In busy urban hospitals, overcrowding, and reduced government financial support are common. These conditions make it difficult to rapidly identify patients with AMI and begin the necessary treatment. To permit urban hospitals to provide more efficient emergency service, the following suggestions are made: increases in nursing staff, implementation of standardized protocols for evaluating patients with suspected AMI, and better availability of electrocardiograms (ECG) and thrombolytic therapy in the emergency room. (Consumer Summary produced by Reliance Medical Information, Inc.)

Urban health

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The role of hospital delivery systems in the treatment of patients with acute myocardial infarction: rural hospital setting

Article Abstract:

Access to health care is an important concern for people living in rural areas. Studies have shown that many rural hospitals have a shortage of qualified nurses and doctors. It is estimated that 6 percent of the rural counties do not have physicians. Long work hours, lack of support, and minimal resources make it difficult for rural hospitals to attract and retain nurses and doctors. Some rural communities rely on volunteer services to provide prehospital care. When the federal government shifted the burden of health care to the state government and local heath care providers, rural hospitals became even more depleted and many closed. Since 1981, at least 550 rural hospitals have been forced to close. In rural communities that only have one hospital, hospital closure means that access to emergency care may become nonexistent. Rural communities are beginning to depend on emergency medical services (EMS) and all available health care professionals for the required medical services. Providing fast and proper emergency medical care for patients experiencing myocardial infarction (heart attack) is a real challenge in rural communities. Timing is crucial for patient survival and requires medical personnel, proper medical protocols, and communication systems between communities to ensure the rapid transport and treatment of the patient. (Consumer Summary produced by Reliance Medical Information, Inc.)

Hospitals, Rural, Rural hospitals

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