title: An organized system of emergency care for patients with myocardial infarction: a reality?
abstract: An organized system of emergency care is an essential requirement for the modern treatment of ST-elevation acute myocardial infarction. There is a strong need to deliver reperfusion therapy as soon as possible, with primary percutaneous coronary intervention being the preferred option if performed in a timely manner and thrombolytic therapy, particularly in the prehospital setting, being a good alternative if the primary percutaneous coronary intervention-related delay exceeds the equipoise. In this situation, emergency medical services have a primary role in rescuing patients from cardiac arrest, performing prehospital diagnosis, triage and treatment and safely transporting them to the most appropriate cardiological center, including interhospital transfer. A complete reorganization of the healthcare systems in different countries is frequently needed to build an ST-elevation acute myocardial infarction system of care, focusing on fast transport, use of telemedicine and diversion protocols to skip the unsuited centers.
authors.affiliation: Cardiovascular Department, San Filippo Neri Hospital, Rome, Italy. m.tubaro@alice.it
authors.forename: Marco
authors.initials: M
authors.lastname: Tubaro
mesh_terms: D000328:Adult; D004632:Emergency Medical Services; D005260:Female; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000175:diagnosis / Q000628:therapy; D014481:United States