STAFFING AND EQUIPPING EMERGENCY MEDICAL-SERVICES SYSTEMS - RAPID IDENTIFICATION AND TREATMENT OF ACUTE MYOCARDIAL-INFARCTION

Each year, about 1,250,000 people in the United States experience an a cute myocardial infarction (AMI). Emergency medical services (EMS) sys tems play a key part in the prehospital care and transportation of AMI patients. Rapid, state-of-the-art treatment by EMS personnel is essen tial for improving AMI survival and outcomes, as dramatized by the pat ient who is the victim of out-of-hospital cardiac arrest. In order to improve the prehospital care provided to AMI patients, this article by the Access to Care Subcommittee of the National Heart Attack Alert Pr ogram Coordinating Committee makes a number of recommendations regardi ng the staffing and equipping of EMS systems. The recommendations cove r the ''chain of survival'' concept, universal and enhanced 9-1-1, eme rgency medical dispatching, ground ambulance specifications, automated external defibrillators, advanced life support coverage, medical dire ction, 12-lead electrocardiograms, and prehospital thrombolysis.