Skip to main content
SpringerLink
Log in

Pre-hospital management of acute myocardial infarction

  • Published:
Irish Journal of Medical Science Aims and scope Submit manuscript

Abstract

Two-hundred and eleven Irish GPs responded to a questionnaire survey of their experience and management of acute myocardial infarction (MI) and their attitudes to the use of thrombolytic therapy. Three-quarters of the respondents felt they dealt with three or more MIs per year; most felt that themajority of MIs were initially seen by a GP. Diagnosis is based on clinical findings; only 11% routinely take an ECG. Management is largely oriented to relief of pain but intravenous narcotics are only used by a minority.

Hospital referral for suspected acute MI was the preferred choice for almost all GPs in a variety of patient-care scenarios. Home care for MI was chosen only for a minority of elderly patients when some hours had elapsed since the onset of symptoms.

Definitive guidelines on the pre-hospital use of thrombolysis are not yet available. However, eighty per cent of respondents in this study feel that thrombolysis is beneficial and many feel that it has value in the pre-hospital situation. Respondents identified educational, organisational and financial problems to be overcome before this could happen.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Report on Vital Statistics, 1987. Central Statistics Office, Dublin, 1990.

  2. Gruppo Italiano Per Lo Studio Delia Streptochinasi Nell ’ Infarto Miocardio (GISSI). Effectiveness of intravenous thrombolytic therapy in acute myocardial infarction. Lancet 1986: 1, 397–402.

    Google Scholar 

  3. ISIS-2 Collaborative Group. Randomised trial of intravenous streptokinase, oral aspirin, both or neither among 17,187 cases of suspected acute myocardial infarction. Lancet 1988: 2, 349–60.

    Google Scholar 

  4. Wilcox, R. G., von der Lippe, G., Olsson, C. G.et al. Trial of tissue plasminogen activator for mortality reduction in acute myocardial infarction. Anglo-Scandinavian Study of Early Thrombolysis (ASSET). Lancet 1988: 2, 525–530.

    Article  PubMed  CAS  Google Scholar 

  5. Rawles, J. M., Haites, N. E. Patient and general practitioner delays in acute myocardial infarction. BMJ 1988: 296, 882–884.

    PubMed  CAS  Google Scholar 

  6. Report of a British Heart Foundation Working Group. Role of the general practitioner in managing patients with myocardial infarction: impact of thrombolytic treatment. BMJ 1989: 299, 555–557.

    Google Scholar 

  7. Fresco, C, Maggioni, A. P., Tognoni, G. Epidemiology of the avoidable delay in patients with acute myocardial infarction admitted to the coronary care unit. Ital. Cafdiol. 1990: 20(4), 361–7.

    CAS  Google Scholar 

  8. Timmis, A. D. Early diagnosis of acute myocardial infarction. BMJ 1990: 301, 941–2.

    PubMed  CAS  Google Scholar 

  9. Colquhon, M. C. General practitioners use of electrocardiography: relevance to early thrombolytic therapy. BMJ 1990: 299, 433.

    Google Scholar 

  10. Pell, A., Stuart, P., Stewart, M., Fraser, D. Home or hospital care for acute myocardial infarction. Br. J. Gen. Pract. 1990: 40, 323–325.

    PubMed  CAS  Google Scholar 

  11. Rawles, J. M. General practitioner management of acute myocardial infarction and cardiac arrest: relevance to thrombolytic therapy BMJ 1987: 295, 639–40.

    CAS  Google Scholar 

  12. Fox, K. A. A. Thrombolysis and the general practitioner. BMJ 1990: 300, 867–868.

    PubMed  CAS  Google Scholar 

  13. Gordan, I. Streptokinase used in general practice. JRCGP 1989: 39, 49–51.

    Google Scholar 

  14. Petch, M. C. Coronary thrombolytic therapy at home. BMJ 1991: 302, 1287–8.

    Article  PubMed  CAS  Google Scholar 

  15. Kay, C. Management of myocardial infarction in the community; a new RGCP study. Br. J. Gen. Pract. 1991: 41, 89–92.

    PubMed  CAS  Google Scholar 

  16. Mason, C, Murdoch, J. C. Current opinion concerning the treatment of heart disease. JRCGP 1983; 33: 91–99.

    CAS  Google Scholar 

  17. Oliver, B., Meagher, N., Cole, M. The present state of general practice in the Republic of Ireland. Modern Medicine of Ireland, Supplement, March 1984.

  18. Davies, A. Electrocardiogram in general practice. BMJ 1989: 299, 408–9.

    PubMed  CAS  Google Scholar 

  19. O’Riordan, M., Kingston, S., O’Regan, P. A Provincial Hospital CCU after ISIS-2. Irish Journal of Medical Science 1991: 160, 176–178.

    PubMed  CAS  Google Scholar 

  20. Mulkerrin, E. C, Dewar, R., Condon, C., Curran, J., Bayer, A., J., Laher, M. S. A retrospective study of myocardial infarction occurring in elderly patients in a coronary care unit. Irish Journal of Medical Science 1991: 160, 257–258.

    Article  PubMed  CAS  Google Scholar 

  21. The Council of the Royal College of General Practitioners. Guidelines for admitting patients with myocardial infarction to hospital. JRCGP 1974: 24, 829–831.

    Google Scholar 

  22. MacMahon, B., Kelly, P., Brangan, P., Walsh, M. J. Report on the Dublin Cardiac Ambulance Service. IMJ 1983: 76, 168–170.

    PubMed  CAS  Google Scholar 

  23. Mulcahy, R. Dublin’ s Mobile Coronary Care Service. IMJ 1984: 77, 62.

    Google Scholar 

  24. Cobbe, S., Redmond, M., Watson, J., Hollingsworth, J., Carrington, D. “Heartstart Scotland ” - initial experience of a national scheme for out of hospital defibrillation. BMJ 1991: 302, 1517–1520.

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of General Practice Professional Unit, University College, Dublin

    A. W. Murphy, R. Power, K. Ungruh & G. Bury

Authors
  1. A. W. Murphy
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. R. Power
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. K. Ungruh
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. G. Bury
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Murphy, A.W., Power, R., Ungruh, K. et al. Pre-hospital management of acute myocardial infarction. I.J.M.S. 161, 593–596 (1992). https://doi.org/10.1007/BF02942365

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02942365

Keywords

Search

Navigation