To the Editor.—
The threat of preventable sudden death in the first minutes and hours of myocardial infarction has led to the development of a number of systems of specialized transport for patients so afflicted (Table). They range downward in sophistication and cost from mobile, professionally attended coronary care units. Another approach, applicable to many Americans, is suggested by the following scheme. The location of the coronary care unit and the patient may be taken as fixed. The ambulance may be placed anywhere.
CCU-Ambulance-Patient-Automobile
On the average, the patient who has a private automobile and a driver immediately available to him can get to the hospital nearly as quickly as the ambulance can get to him. Unless the ambulance is specially and expensively equipped and manned, or fortuitously near, he achieves a distinct time advantage by being driven to the hospital.
Perhaps the patient ought to stay still until the
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