Rawles J
Medicines Assessment Research Unit, University of Aberdeen.
Br J Gen Pract. 1992 Dec;42(365):525-8.
Pre-hospital coronary care usually consists of a medically staffed coronary care ambulance going into the community from a hospital base, as pioneered in Northern Ireland. In today's medicopolitical and economic climate, this model is not viable in mainland United Kingdom. Current proposals seem to favour a 'scoop and run' policy for heart attack victims, that utilizes the ambulance service but bypasses the general practitioner. Since the majority of telephone calls from people with suspected myocardial infarction are directed to general practitioners, a preferable alternative would be a 'stay and stabilize' strategy that uses the existing referral pattern and builds on general practitioners' medical education and skills. The role of the general practitioner in the management of patients with suspected myocardial infarction is discussed.
院前冠心病护理通常包括一辆配备医务人员的冠心病护理救护车从医院基地进入社区，这一模式由北爱尔兰首创。在当今的医疗政治和经济环境下，这种模式在英国本土不可行。目前的提议似乎倾向于对心脏病发作患者采取“接走即送”政策，即利用救护车服务但绕过全科医生。由于大多数疑似心肌梗死患者的电话都打给了全科医生，一个更可取的替代方案可能是“留观并稳定病情”策略，该策略利用现有的转诊模式，并基于全科医生的医学教育和技能。本文讨论了全科医生在疑似心肌梗死患者管理中的作用。
