CCU network as primary care of acute myocardial infarction

The early pre-hospital care of patients with acute myocardial infarction (AMI) is critical because of high mortality during acute phase of AMI. A CCU network has been established by the Metropolitan Tokyo CCU Communication Society and the help of the Ambulance Units through the Control Room of the Tokyo Fire Department, performing ECG telephone line transmission and telephone consultation. Out of 1439 patients admitted by means of CCU network during the 8-month period (Jan. 1982-Aug. 1982), 505 (30.3 percent) had AMI as a final cardiac diagnosis. Many patients were admitted directly to the CCU by ambulance from the place where the patient was located, with the shortest overall time of 7 hours 25 minutes. Fifty-three percent of patients with AMI were admitted within 6 hours after the onset of symptoms. The mean patients' decision time was 9 hours 48 minutes, which comprised one half of the overall period as well as physician delay of 6 hours 36 minutes on the average. Thus, community oriented educational programs to more fully inform the population and individual hospital evaluations to hospitalize patients with chest discomfort are needed in order to shorten the decision time and physician delay expediting the care of these patients.