British medical journal
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British medical journal · Feb 1975
Follow-up of emergency ambulance calls in Nottingham: implications for coronary ambulance servie.
Information about patients in ambulance service records has been linked to that in the patients' hospital records in an attempt to make the most efficient use of a special ambulance service for patients suspected of having heart attacks. During one week 248 emergency (999) calls for an ambulance were made by the public in the city of Nottingham. The quality of information given to the ambulance centre was poor, and all four patients eventually found to have had a myocardial infarction were described as having collapsed. A further study of patients who were also described as having collapsed has led to a system which allows an ambulance controller to send a "coronary ambulance" only in answer to those emergency calls where there is a reasonable possibility that the patient has had a heart attack.
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The rebreathing method of measuring oxygenated mixed venous Pco(2) (Pvco(2)) was originally introduced as a bloodless way to estimate arterial Pco(2) (Paco(2)). It has become common practice to subtract 6 mm Hg from the Pvco(2) to obtain the Paco(2) but there are many circumstances in which this leads to an overestimate of the Paco(2). ⋯ These studies also showed that the Pvco(2) - Paco(2) difference may be much wider, particularly in the presence of arterial unsaturation and a low cardiac output. The factors governing the venoarterial Pco(2) difference are reviewed and their magnitude is calculated to emphasize the complementary roles of measurements of Pvco(2) and Paco(2) in the assessment of patients with cardiorespiratory disease.