Effect of mobile paramedic units on outcome in patients with myocardial infarction

To investigate the effect of mobile paramedic units on outcome, we prospectively studied for two years all patients with myocardial infarction admitted to the LDS Hospital emergency department who sought aid prior to cardiac arrest. One hundred thirty-four patients who received prehospital care from a mobile paramedic unit were compared with 101 patients who selected another means of initial care. Mortality, occurrence of life-threatening arrhythmias, and change in Killip class at 24 and 48 hours were the outcome variables. Data analysis by multiple logistic regression revealed that outcome was not improved, but a 29-minute median delay in hospital arrival occurred in paramedic-treated patients. Defibrillation was the only beneficial treatment performed by paramedics that could be identified. Current mobile paramedic unit procedures may need to be streamlined to eliminate the delay in hospital arrival resulting from extensive prehospital care.