MOBILE CORONARY CARE UNIT

ARCHA VIJAYAN
 INTRODUCTION
• 1971 Cox Medical Center became one of the first
hospitals in the nation with a Mobile Coronary Care
Unit.
• Prehospital coronary care is becoming a common
feature of community emergency medical systems.
• About 80% of OHCAs will likely to benefit from
admission to a centre with acute coronary care facilities,
including immediate access to percutaneous coronary
intervention (PCI). 
 Features…
• Selected patients with a high suspicion of coronary obstructive
disease, may benefit from early transport for coronary
intervention while CPR is continued
• More than half the patients dying from myocardial infarction do
not reach the hospital.
• A specially designed mobile coronary care unit has been
introduced for coronary care. 
• The monitored infarct patient is stabilized and taken to the
nearest hospital having a coronary care unit
• Since the majority of deaths from coronary heart disease occur
early and outside the hospital, the importance of the prehospital
phase is emphasized.
• The delay in this period, which is very dangerous for the patient,
should be reduced and mobile coronary care units (MCCU's)are
one possibility to reduce the rate of sudden coronary death. 
WHAT IS MOBILE CARE UNITS
• Mobile Coronary Care Unit (Mobile CCU) is an intensive care unit on
wheels that transports cardiac and critical care patients to Hospital
from outlying areas.
• This specially equipped ambulance is outfitted with the same state-of-
the-art monitoring systems, equipment and life-saving
pharmaceuticals used in the hospital's intensive care units.
• On-board equipment includes a full array of comprehensive
monitoring devices as well as a team of highly-skilled professionals. 
• The healthcare team includes a paramedic/
emergency medical technician and a registered nurse, with extensive
cardiovascular/critical care training unit.
• The Mobile CCU also will transport patients for

outpatient services or direct hospital admission from

other hospitals, physician's offices or urgent care

facilities, or long term care facilities

 Care …….
• On arriving at the site an electrocardiogram is taken, the
monitor is attached to the patient, and an intravenous is begun.
• Cardia care support measures are initiated
• Adm Ionotropic drugs
• Stabilizing vitals
• Starting of CPCR
• Appropriate treatment for arrhythmia may be given by drugs or
electrical cardioversion.
• If needed emergency THROMBOLYTICS OR EVEN PTCA
can be done
 Care ……….
• Early initiation of intensive care outside may prevent ventricular
fibrillation.
• The correction of ventricular fibrillation outside hospital is a
practical proposition.
• A properly organized mobile coronary care unit removes the
risk of death during transport.
• The early initiation of intensive care and the correction or
prevention of dysrhythmias and associated hypotension
diminish the incidence of shock and pump failure by preventing
the extension of the initial area of infarction
 Care…….
• Initiation of immediate emergency care
• Continue to provide emergency care
• Continue monitoring vital signs.
• Communicate with ED personnel.
• Give a description of what happened.
• Describe patient, age, sex and his condition
Patient vital signs
Emergency care that has been provides.
Estimated time of arrival
 indications
• Cardiac arrhythmias
• Ventricular arrhythmias
• Supraventricular tachycardia
• Supraventricular brady-arrhythmia
• Cardiac arrest
• Cardiac failure
• Cardiogenic shock
 team
The personnel includes an
• Attending physician
• Resident physician
• Emergency room nurse
• ECG technician
• Driver
• Assistant
 Design……..

Specially designed mobile central trolley

• Adjusts to desired height. 
• Easily tipped into Trendelenberg position for shocked patients.
• Head end elevation for dyspneic patients..
• Arm rests for intravenous therapy.
• Ample working space around trolley.
• Shelves and cupboards support and accommodate equipment.
• Small hand wash basin with pumped up warm water.
• Seating accommodation for four.
• Powerful fluroscent lighting.
• Spot light.
• A static invertor run off an extra 12 volt heavy duty battery
• Monitoring and Resuscitation equipment all battery powered
• Defibrillator
• Oscilloscope
• CPAP ventilator
• Electrocardiograph
• Pacemaker
• Suction apparatus
•  O2 cylinder fixed in ambulance.
• Respiratory equipment
• Ambu bag
• Brooke airways
• Endotracheal tubes
• Usual nursing dressing and accessories
• Drug case with cardiovascular drug and special drug(usual drug replaced on arrival to hospital.
• Iv infusion bottles supported by roof mounted brackers
 Care …….
• On arriving at the site an electrocardiogram is taken, the
monitor is attached to the patient, and an intravenous is begun.
• Cardia care support measures are initiated
• Adm Ionotropic drugs
• Stabilizing vitals
• Starting of CPCR
• Appropriate treatment for arrhythmia may be given by drugs or
electrical cardioversion.
• If needed emergency THROMBOLYTICS OR EVEN PTCA
can be done
 Care ……….
• Early initiation of intensive care outside may prevent ventricular
fibrillation.
• The correction of ventricular fibrillation outside hospital is a
practical proposition.
• A properly organized mobile coronary care unit removes the
risk of death during transport.
• The early initiation of intensive care and the correction or
prevention of dysrhythmias and associated hypotension
diminish the incidence of shock and pump failure by preventing
the extension of the initial area of infarction
 Care…….
• Initiation of immediate emergency care
• Continue to provide emergency care
• Continue monitoring vital signs.
• Communicate with ED personnel.
• Give a description of what happened.
• Describe patient, age, sex and his condition
Patient vital signs
Emergency care that has been provides.
Estimated time of arrival