Emergency Medical Service Use among Patients with Acute ST-segment Elevation Myocardial Infarction in Jeonbuk Province

Woo, Sun Ho; Yun, Kyeong Ho; Lee, Mi Rim; Kim, Eun Kyoung; Ko, Jum Suk; Rhee, Sang Hoon; Lee, Jeongmi; Kim, Nam Ho; Oh, Seok

doi:10.3904/kjm.2016.90.6.507

Cited by 3 publications

(6 citation statements)

References 17 publications

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“…Moreover, approximately 16.8% selected inappropriate coping behavior such as going to hospital or oriental hospital and contacting the family, which would delay the patient’s hospital arrival. It would be necessary to provide training and campaigns stressing that the 911 ambulance services are not mere transportation vehicles but a crucial primary medical service offering diagnosis and treatment [ 7 ].…”

Section: Discussionmentioning

confidence: 99%

“…It was reported in a qualitative study with MI patients that patients lacked an understanding of atypical symptoms and had incorrect perceptions regarding the use of emergency medical service, perceiving that using the service was embarrassing or uncomfortable [ 8 ]. Moreover, there was a misperception that 911 ambulance vehicles should be used only in the presence of severe pain [ 7 ]. Accordingly, to promote the appropriate coping behavior at the onset of MI symptoms (i.e., calling 911), atypical MI symptoms as well as typical symptoms should be emphasized in MI education and training, and campaigns should be aggressively held to raise the awareness among the general public that anyone can call-911 and utilize the service in an emergency.…”

Section: Discussionmentioning

confidence: 99%

“…Inappropriate patient transportation, such as the use of a personal car or contacting the family, causes a delay in the hospital arrival [ 4 ], which leads to the loss of the crucial opportunity to treat MI (i.e., the golden hour), affecting the patient’s likelihood of survival [ 6 ]. Studies have shown that only 28.8% of MI patients used the 911 service, that they used the service only when in severe pain [ 7 ], and that they had incorrect perceptions of the service and felt embarrassed or uncomfortable using it [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

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Predictors of anticipated coping behavior at myocardial infarction symptom onset among a nationwide sample of Korean adults

Park¹

2021

Epidemiol Health

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OBJECTIVES This cross-sectional study based on the health belief model investigated predictors of anticipated coping behavior at myocardial infarction (MI) symptom onset using secondary data from the 2017 Korea Community Health Survey. METHODS Modifying variables (socioeconomic, health knowledge, perceived threat) were selected as independent variables and anticipated coping behavior at MI symptom onset as the dependent variable. Calling 911 was classified as the correct anticipated coping behavior, while visiting a hospital or an oriental hospital, calling family, and others were classified as incorrect. RESULTS Of 227,740 participants, 83.2% reported correct anticipated coping behaviors. The likelihood of calling 911 was low if participants experienced atypical symptoms (jaw, neck, back, arm, and shoulder pain), even if they were aware of those symptoms. However, 69.9% of participants who were aware of typical symptoms (chest pain) stated that they would call-911. Sex, age, hypertension, dyslipidemia, obesity, and awareness of MI symptoms affected the correct anticipated coping behavior. CONCLUSIONS Correct coping abilities among the general public are vitally important for early treatment of MI patients and reduction of hospitalization time. Members of the general public in their 20s and 30s, 60 years of age or older, with cardiovascular risk factors (male sex, hypertension, dyslipidemia, and obesity), and who are not aware of MI symptoms should be educated about the typical and atypical symptoms of MI. Emergency medical services should be called without delay if needed, and public relations activities should be carried out to raise awareness that anyone can use emergency medical services.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Predictors of anticipated coping behavior at myocardial infarction symptom onset among a nationwide sample of Korean adults

Park¹

2021

Epidemiol Health

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“… 4 5 Therefore, it is important for patients to recognize their symptoms early and visit an emergency medical center promptly. 6 …”

Section: Introductionmentioning

confidence: 99%

Comparison of Prognosis According to the Use of Emergency Medical Services in Patients with ST-Segment Elevation Myocardial Infarction

Kim

Jeong

et al. 2022

Yonsei Med J

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Purpose This study aimed to compare long-term clinical outcomes according to the use of emergency medical services (EMS) in patients with ST-segment elevation myocardial infarction (STEMI) who arrived at the hospital within 12 hr of symptom onset. Materials and Methods A total of 13104 patients with acute myocardial infarction were enrolled in the Korea Acute Myocardial Infarction Registry–National Institutes of Health from October 2011 to December 2015. Of them, 2416 patients with STEMI who arrived at the hospital within 12 hr were divided into two groups: 987 patients in the EMS group and 1429 in the non-EMS group. Propensity score matching (PSM) was performed to reduce bias from confounding variables. After PSM, 796 patients in the EMS group and 796 patients in the non-EMS group were analyzed. The clinical outcomes during 3 years of clinical follow-up were compared between the two groups according to the use of EMS. Results The symptom-to-door time was significantly shorter in the EMS group than in the non-EMS group. The EMS group had more patients with high Killip class compared to the non-EMS group. The rates of all-cause death and major adverse cardiac events (MACE) were not significantly different between the two groups. After PSM, the rate of all-cause death and MACE were still not significantly different between the EMS and non-EMS groups. The predictors of mortality were high Killip class, renal dysfunction, old age, long door-to-balloon time, long symptom-to-door time, and heart failure. Conclusion EMS utilization was more frequent in high-risk patients. The use of EMS shortened the symptom-to-door time, but did not improve the prognosis in this cohort.

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“…As a result, 95.7% of STEMI patients admitted to regional cardiovascular centers during 2011 achieved PCI within 90 minutes [ 10 ]. However, more than half of STEMI patients are referred to PCI after visiting the emergency department of a non-PCI capable hospital first [ 11 ]. According to Kim et al [ 12 ] and Park et al [ 13 ], 60.9% of STEMI patients visit non-PCI capable hospitals initially and are subsequently transferred to hospitals with a PCI facility, and the D1-to-B time of 120 minutes was observed only in 29.3% of such STEMI cases.…”

Section: Introductionmentioning

confidence: 99%

Effect of percutaneous coronary intervention team prenotification based on real time electrocardiogram transmission in interhospital transfer of ST elevation myocardial infarction patients: pilot trial of Preparing Revascularization Effort before Patients’ Arrival via Regionalization Engagement protocol

et al. 2020

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Objective Prompt reperfusion is important for patients with ST elevation myocardial infarction (STEMI). However, patients often require interhospital transfer for percutaneous coronary intervention (PCI) because not all hospitals can provide. The purpose of this study is to reduce the PCI delay using a regionalization protocol in patients with STEMI following transfer from another hospital lacking PCI facility. Methods We established a revascularization protocol designated as Preparing Revascularization Effort before Patients' Arrival via Regionalization Engagement (PREPARE) for the STEMI patients transferred from an outside regional hospital. The protocol included immediate referral acceptance by an emergency physician, real-time electrocardiogram sharing via mobile phone and early activation of the PCI team. We analyzed the differences between the PREPARE and the non-PREPARE groups. Results In the PREPARE group, the median time from the first hospital visit to the ballooning procedure via PCI at the receiving facility (D1-to-B time) was 111.0 (interquartile range 97.0-130.0) minutes, which was significantly shorter than in the non-PREPARE group 134.0 (interquartile range 115.0-182.0) minutes. The proportion of D1-to-B time within 120 minutes was 30.4% in the group and 60.0% in the PREPARE group, which represents a significant difference (P = 0.004). Multivariate logistic regression analysis revealed that patient transfer via PREPARE protocol (odds ratio, 3.399; 95% confidence interval, 1.150-10.050, P = 0.027) was related to adequate D1-to-B time. No statistically significant differences were found in the hospital length of stay or major adverse cardiac events within 4 weeks. Conclusion The PREPARE protocol is an effective strategy to reduce the time to revascularization of the transferred STEMI patients.

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Emergency Medical Service Use among Patients with Acute ST-segment Elevation Myocardial Infarction in Jeonbuk Province

Cited by 3 publications

References 17 publications

Predictors of anticipated coping behavior at myocardial infarction symptom onset among a nationwide sample of Korean adults

Predictors of anticipated coping behavior at myocardial infarction symptom onset among a nationwide sample of Korean adults

Comparison of Prognosis According to the Use of Emergency Medical Services in Patients with ST-Segment Elevation Myocardial Infarction

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