ABSTRACT

Background: Prehospitalary medicine made in ambulances with advanced vital support equipment while the patient is carried on to the hospital has lead to a reduction in mortality of subjects with a sudden organ failure. Objectives: To give a perspective about the prehospitalary medical services offered in 10 years in Mexico city. Methods: Descriptive analysis of the information. Results: Our medical service assisted 10,250 patients (44% women), with a mean age of 53 years. The average response time from requesting the service until contact with patients was 73 min. Transportation to hospitals or between hospitals were the predominating service. Major disorders motivating our services were of cardiovascular (21%), traumatic (19%) and neurologic (17%) nature. Cardiopulmonary and encephalic resuscitation was done in 341 cases, from which 256 the cardiopulmonary arrest occurred before arrival of the medical team. We considered that life was saved in 3.3% of patients, while 40.9% received advanced vital support with tracheal intubation and mechanical ventilation. On the contrary, 18% did not require any support. Conclusions: More awareness among health personnel and general population about the benefits of an opportune treatment with specialized medical personnel on well-equipped ambulances is needed.

KEYWORDS

Prehospitalry medicine, critical medicine, advanced life suppor, ambulance transportation.

REFERENCES

1. Bainton CR, Peterson DR. Deaths from coronary heart disease in persons 50 years and younger. A community-wide study. New Engl J Med 1963; 268: 569-575.

2. Yu PN. Prehospital care of acute myocardial infarction. Circulation 1972; 45: 189-204.

3. Pantridge JF. Prehospital coronary care. Br Heart J 1974; 36: 233-237.

4. Pantridge JF, Geddes JS. Mobile intensive care unit in management of myocardial infarction. Lancet 1967; II: 271.

5. Carveth SW, Olson D. Emergency medical care system. Arch Surg 1974; 108: 528-530.

6. Cameron M, Wilkinson F. Follow-up of emergency ambulance calls in Nottingham: implications for coronary ambulance service. Br Med J 1975; 1: 384-386.

7. Dewar HA, McCollum JP. A year’s experience with a mobile coronary resuscitation unit. Br Med J 1969; 4: 226-229.

8. Baskett PJ, Diamond W. Urban mobile resuscitation; training and service. J Anaesth 1976; 48: 377-384.

9. Melker RJ. Medical transport: practice and issues. En: Lumb PD, Shoeniaker WC (editores) Critical care state of the art. The society of critical care medicine. Philadelphia: Saunders, 1987.

10. Waddell G, Scott PD. Effects of ambulance transport in critically-ill patients. Br Med J 1975; 1: 386-389.

11. Pozen MW, Fried DD, Voigt GG. Studies of ambulance patients with ischemic heart disease. II. Selection of patients for ambulance telemetry. Am J Public Health 1977; 67: 532-535.

12. Pozen MW, Fried DD, Smith S, Lindsay LV, Voigt Gc. Studies of ambulance patients with ischemic heart disease. 1.The outcome of pre-hospital life-threatening arrhythmias in patients receiving electrocardiographic telemetry and therapeutic interventions. Am J Public Health 1977; 67: 527-531.

13. Cowley R, Dunmah C. Introduction. En: Cowley R, Dunmah C (editores). Shock-trauma critical care manual. Baltimore: University Park Press, 1982.