Giornale italiano di cardiologia
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Feasibility, safety and efficacy of prehospital management of acute myocardial infarction (AMI) and prehospital thrombolysis have been widely demonstrated. On this background, in March 1992 we started up an Emergency Medical Service (EMS)--Servizio per le Emergenze Cardiologiche Territoriali, SECT--aimed to prehospital care of overall cardiac emergencies (CE), including AMI. The Service, operating in the metropolitan area of Turin (130 Km2, 964,000 inhabitants), is based on a properly equipped ambulance, manned with a physician and a nurse, skilled in treatment of CE. ⋯ Our experience confirm efficacy of out-of-hospital management of AMI within an EMS designed to treat overall CE, considering successful treatment of complications and early thrombolysis with reduction of time delay. Inclusion of SECT in the growing up "118" Emergency Medical System raises logistic questions. Process will be completed when the "medical final authority" will submit each intervention to a full evaluation in terms of efficiency and efficacy, and will not only prepare, as now happens, dispatch and intervention protocols.