ABSTRACT
INTRODUCTION The concept of prehospital management of myocardial infarction was introduced in the mid-1960s in recognition of the very substantial loss of life occurring before patients could be admitted to the hospital. At a time when there was no effective treatment for the majority of patients with this condition, 60% of patients died within the first hour and many failed to reach a hospital within the first 12 hours [1]. At present, each year around 800,000 people in the United States suffer an acute myocardial infarction (MI) and at least 213,000 will die as a result. Surveys show more than 50% of these deaths are still within the first hour, with the percentage rising to 80% within the first 24 hours [2,3]. Despite the recognized improvement in mortality of those reaching the hospital, this has not been matched by the same improvement in prehospital mortality.
