Establishment of the Melbourne mobile intensive care service

As the majority of deaths after infarction occur in the first hour, a mobile intensive care ambulance service has been instituted in Melbourne to enable adequate care and early monitoring facilities. Initially the service was manned by doctors and ambulance officers, but currently each ambulance is manned by two specially trained officers. Over a 27-month period 52 patients have been resuscitated from ventricular fibrillation or ventricular standstill. Half of the patients had sustained a definite acute myocardial infarction and another 16 had probable but not proven myocardial infarction. Of the 52 patients, 31 survived to leave hospital and all patients known to be alive are leading active and useful lives. In spite of an initial fear that medical treatment might be overused or misused by the officers, this has not been the case, and only about 13% of patients have received drugs from the officers. This paper deals with the setting up, staffing and training of the ambulance service and reviews its results.