[Effectiveness of specially equipped and staffed ambulances in the immediate treatment of cardiac emergencies (author's transl)].

Of 3079 medically justified calls of the special ambulances at Ludwigshafen 70.6% were medical emergencies, of which 1059 were cardiac emergencies, 66.9% of these being myocardial infarctions. One quarter of patients with the typical features of myocardial infarction died in the first few minutes, one third within the first half-hour of onset of symptoms. The use of the special ambulances markedly raised the severity of those cases of infarction admitted to hospital so that, despite appropriate therapeutic measures in the early phase, total mortaltiy of cases of myocardial infarction treated by ambulance and at hospital was 51.1%. On the other hand, very early measures (mechanical and electrical resuscitation, intravenous infusion) can be of decisive importance in patients who would otherwise die as a result of arrhythmias. Long-term survival had been achieved in 29% before use of the special ambulance, in 46.8% after its introduction. No correspondingly good results through very early treatment were achieved after attempted suicide: the death rate was 2.6% both before and after introduction of the special ambulances (470 and 497 cases, respectively).