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British Journal of General Practice
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Research Article

The management of suspected myocardial infarction by Scottish general practitioners with access to community hospital beds.

R Liddell, J Grant and J Rawles
British Journal of General Practice 1990; 40 (337): 318-322.
R Liddell
Department of Medicine and Therapeutics, University of Aberdeen.
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J Grant
Department of Medicine and Therapeutics, University of Aberdeen.
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J Rawles
Department of Medicine and Therapeutics, University of Aberdeen.
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Abstract

General practitioners working in 20 community hospitals in Scotland participated in a survey of the management of myocardial infarction. During one year they suspected acute myocardial infarction in 451 patients. Of these patients, 278 (62%) were admitted to a community hospital, 125 (28%) to a district general hospital and 48 (11%) were kept at home. The main reasons given for admission to a community hospital were for monitoring and investigation, while the main reasons for admission to a district hospital rather than a community hospital were the relative youth of the patient and the severity of the illness. Acute myocardial infarction was confirmed in 323 (72%) cases, but in 26 (6%) cases the final diagnosis was other than ischaemic heart disease. Patients with acute myocardial infarction who entered a community hospital did so a median of two hours 25 minutes after the onset of symptoms. Among 18 patients admitted to a community hospital in whom resuscitation was attempted after cardiac arrest four (22%) were subsequently discharged from hospital. The mortality rate from acute myocardial infarction in the community studied was 171/418 (41%), of whom 95 died suddenly before coming under medical care. It is concluded that in rural areas of Scotland an acceptable standard of care for patients with acute myocardial infarction, including the administration of thrombolytic therapy, could be provided rapidly by general practitioners working in community hospitals.

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British Journal of General Practice: 40 (337)
British Journal of General Practice
Vol. 40, Issue 337
August 1990
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The management of suspected myocardial infarction by Scottish general practitioners with access to community hospital beds.
R Liddell, J Grant, J Rawles
British Journal of General Practice 1990; 40 (337): 318-322.

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The management of suspected myocardial infarction by Scottish general practitioners with access to community hospital beds.
R Liddell, J Grant, J Rawles
British Journal of General Practice 1990; 40 (337): 318-322.
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