Prehospital and hospital coronary care.

This article reviews the current state of services for coronary care. Since the majority of deaths from coronary heart disease occur early and outside the hospital, the importance of the prehospital phase is emphasized. The delay in this period, which is very dangerous for the patient, should be reduced and mobile coronary care units (MCCU's) are one possibility to reduce the rate of sudden coronary death. Different systems of MCCU's are discussed: (1) those based on a hospital coronary care unit, usually accompanied by a nurse and/or a doctor and (2) those integrated into an already existing decentralized emergency system (e.g. fire department) run by paramedics. Although long-term survival of patients resuscitated from ventricular fibrillation is not so good, the results of many of these units are remarkable.