The impact of a physician-staffed mobile intensive care unit.

In the United States, mobile intensive care units (MICU) staffed by paramedical personnel are the means by which virtually all patients are transported to hospitals. However, in many other countries, MICUs are physician-staffed. The role of physicians in the MICU in delivering emergency pre-hospital care in Israel was examined. In one year's experience on a physician-attended MICU, 1,200 of 3,919 patients (31%) were definitively treated in the pre-hospital phase and not transported to a hospital facility. A careful follow-up of these patients is reported. In 235 cases death was pronounced by the MICU physician, and the patient was not transported. In 965 cases, the problem was diagnosed and the patient treated without a referral for further immediate treatment. Follow-up was obtained for 869 (90%) of these patients, of whom 843 (97%) required no additional emergency attention during the 48-hour follow-up period. The use of a physician-attended MICU reduces the service load on emergency departments.