Patient identification and bystander-initiated actions in acute myocardial ischemia.

From the onset of symptoms of acute myocardial ischemia to initiation of emergency medical services is a delay over which health-care professionals have the least control. Treatment modalities greatly depend upon rapid recognition and early therapy. Patient identification of specific symptoms can be helpful and recognition can be improved by targeted, public educational efforts. Completion of a seamless 9-1-1 system in Florida is necessary as well as instruction in its proper use. Simplified cardiopulmonary resuscitation instruction needs to be given to those persons most likely to be exposed to a sudden cardiac death victim. The physician's office staff should be educated so they can enlighten patients regarding the need for rapid treatment in acute situations. Appropriate utilization of automatic external defibrillators needs to be studied.