[Family practice management of risk patients with reference to preclinical emergency medicine]

Chances of surviving myocardial infarction or cardiocirculatory arrest depend on an early and appropriate emergency call as well as on bystander CPR. This study uses a questionnaire to assess to what extent these factors guide the private practitioners caring for high-risk cardiac patients. Almost all physicians responding (44%) treat such patients. More than 70% try to include the patients' relatives in a medical briefing. Recognition of early warning signs is discussed with 80% of the patients and 70% of relatives. How to identify acute life-threatening conditions is discussed with 60% of patients and relatives. In case of sudden chest pain and dyspnoea, physicians commonly advise calling the family doctor, a hospital or a regional physician on call. Calling 112, the emergency physician/rescue service, is rarely recommended. Initiating CPR is recommended for an emergency by 30% of the physicians, whereas 20% encourage relatives of patients at risk to take a CPR course. CPR instruction is judged to be generally useful by 50% of physicians, of limited use by 40% and of no use by 10%. When asked why they do not encourage CPR, 15% of physicians said they have no time, 25% cited the inefficiency of the courses, 40% said CPR is psychologically too stressful for laypersons, and 50% felt it was physically too stressful. This study points out the necessity of additional, appropriate instruction of laymen regarding cardiac emergencies.