Call to needle times after acute myocardial infarction

In North Derbyshire, a mix of urban and rural areas adjacent to Sheffield, we have a system of direct admission to the Chesterfield and North Derbyshire Royal Hospital coronary care unit by paramedics (bypassing the accident and emergency department) when the paramedics diagnose an acute myocardial infarction from a 12 lead electrocardiogram obtained at the patient's home. 2 In the 21 months since the system was introduced in May 1997 I have collected data on all admissions to the coronary care unit. If thrombolysis starts to be given in the accident and emergency department in Chesterfield we will have to compare this service with the existing paramedic service and determine if the model proposed by Edhouse et al is even quicker. 1 Call to needle times after acute myocardial infarction [letters].