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Survey of general practitioners' prehospital management of suspected acute myocardial infarction

The effectiveness of thrombolysis in acute myocardial infarction is greater the shorter the time between onset of symptoms and administration of thrombolysis.1 Recent guidelines for the British Heart Foundation suggest that thrombolysis should be given within 90 minutes.2 Debate continues, however, about the best way to give thrombolysis and about the role of general practitioners.3,4 We studied general practitioners' knowledge of and attitudes and behaviour towards patients with suspected acute myocardial infarction and considered the relevance of our findings to the development of district policies.

Between June and August 1992 we sent a questionnaire to all general practitioners (n=205) who refer patients to Plymouth's coronary care unit, where all hospital thrombolysis for myocardial infarction in Plymouth district is given. The district is clearly divided into rural and urban areas, with 143 urban …