Journal Article

Importance of patient selection in evaluating a cardiac ambulance service

Hampton, J R

1976

Overview

All patients brought to hospital by a special cardiac ambulance were followed up and compared with patients carried by routine ambulances to assess the effectiveness of a cardiac ambulance service. The overall mortality of patients with heart attacks was 51% among those carried by an ordinary ambulance and 40% among those carried by the cardiac ambulance. The apparently low mortality in the latter group was balanced, however, by a high mortality (68%) among patients carried by ordinary ambulances when the cardiac ambulance was available but not used; these patients tended to have a short duration of symptoms and heart attacks away from home, and their ambulance was more often called by a member of the public than a general practitioner. It seems therefore that low-risk cases were inadvertently selected for transport by the cardiac ambulance; such unintentional selection makes it difficult to evaluate a cardiac ambulance service.

• Publisher: British Medical Journal Publishing Group,British Medical Association,BMJ Publishing Group LTD
• Subject: Ambulances / Automobiles / Calcium / Contemporary Themes / Coronary Care Units - standards / Coronary Disease - mortality / Coronary Disease - therapy / Electrocardiography / Emergency transportation / Emergency vehicles / England / Evaluation Studies as Topic / Follow-Up Studies / Health Occupations - education / Humans / Mobile Health Units / Mortality / Myocardial infarction / Patient Care Planning / Resuscitation / Symptoms / Transportation of Patients / Vehicles