What causes most myocardial infarction-related deaths, and what can prehospital care providers do to improve outcomes?

Updated: May 07, 2019
  • Author: A Maziar Zafari, MD, PhD, FACC, FAHA; Chief Editor: Eric H Yang, MD  more...
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Answer

Most deaths caused by MI occur early and are attributable to primary ventricular fibrillation (VF). Therefore, initial objectives are immediate ECG monitoring; electric cardioversion in cases of VF; and rapid transfer of the patient to facilitate prompt coronary assessment.

Prehospital integration of ECG interpretation has been shown to decrease "door-to-balloon time,” allow paramedics to bypass non–percutaneous coronary intervation (PCI)–capable hospitals in favor of PCI-capable facilities, and to expedite care by allowing an emergency department physician to activate the catheterization laboratory before the patient's arrival.


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