The rural physician and myocardial infarction: part 1: pre-hospital management.

The majority of patients who succumb to myocardial infarction die before they reach a hospital. Three types of services have been developed to reach and treat patients immediately: the mobile coronary team (Belfast model), the coronary ambulance (American model) and family doctor services. Of the three types, only the family doctor service is practical in most rural communities. Evidence in the literature suggests that it is possible for rural physicians to reduce the mortality from MI in the community by visiting the patient with a suspected attack in the home as quickly as possible. The alternative of bringing the patient to hospital by ambulance before he has received any treatment is probably much less desirable.