Emergency Medical Services Utilization among Patients with ST-Segment Elevation Myocardial Infarction: Observations from the Singapore Myocardial Infarction Registry

Ho, Andrew Fu Wah; Loy, En Yun; Pek, Pin Pin; Wah, Win; Tan, Timothy Xin Zhong; Liu, Nan; Chua, Terrance; Koh, Tian Hai; Chow, Khuan Yew; Ong, Marcus Eng Hock

doi:10.3109/10903127.2015.1128032

Cited by 27 publications

(23 citation statements)

References 28 publications

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“… 23 Moreover, ambulance transportation was used for only 19.4% of patients in provincial cities, 11.6% of patients in prefectures, and 12.0% of patients in counties, whereas 60% to 70% of patients in the US, Canada, the UK, and Japan and 50% of patients in Singapore use ambulances. 24 , 25 , 26 , 27 , 28 , 29 The possible reasons for this are thought to be mainly patients’ being unaware of their AMI and lack of information on EMSs’ performance. Furthermore, EMSs are still underdeveloped and inconvenient in China, especially in rural and remote areas.…”

Section: Discussionmentioning

confidence: 99%

Association of Hospital-Level Differences in Care With Outcomes Among Patients With Acute ST-Segment Elevation Myocardial Infarction in China

Yang

Wang

et al. 2020

JAMA Netw Open

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Key Points Question What are the differences in care and outcomes of patients with ST-segment elevation myocardial infarction among 3 vertical levels of hospitals in China? Findings In this cross-sectional study using data from the China Acute Myocardial Infarction Registry, which included 108 hospitals at the province, prefecture, and county levels, compared with patients in province-level hospitals, the rates of reperfusion therapy were lower among those in prefecture-level and county-level hospitals (69.4% vs 54.3% vs 45.8%). In-hospital mortality rates progressively increased among the 3 levels of hospitals, from 3.1% at the province level to 5.3% at the prefecture level to 10.2% at the county level. Meaning These findings suggest that more efforts should be made to address the gaps in care and outcomes of ST-segment elevation myocardial infarction for national quality improvement in China.

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Section: Discussionmentioning

confidence: 99%

Association of Hospital-Level Differences in Care With Outcomes Among Patients With Acute ST-Segment Elevation Myocardial Infarction in China

Yang

Wang

et al. 2020

JAMA Netw Open

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“…However, many studies concluded that there was underutilization of EMS systems by ACS patients. [3][4][5] For those who experienced chest pain, early contact with health systems, particularly through prehospital medical providers, proved to have a beneficial role in revascularization following the cardiac ischemic event. 6 Multiple studies found that obtaining a pre-hospital electrocardiogram (ECG) will reduce the door-to-balloon time and lead to faster reperfusion therapy with a lower adjusted risk of mortality among ACS patients.…”

Section: Introductionmentioning

confidence: 99%

<p>Electrocardiogram Interpretation Competency Among Paramedic Students</p>

Mobrad¹

2020

JMDH

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Background: Electrocardiography is an essential emergency tool used in the pre-hospital setting. However, no studies have yet assessed electrocardiogram (ECG) interpretation among emergency medical services (EMS) students in Saudi Arabia. This study aimed to determine the ECG interpretation competency of paramedic students. Methodology: Cross-sectional, single-center study, a pre-validated, self-administered, twopart questionnaire first created by Coll-Badell et al was used to assess the ECG interpretation competency of paramedic students at Prince Sultan College for Emergency Medical Services (PSCEMS) in King Saud University. Participant data were collected and analyzed to identify factors associated with improved competency. Results: All students of PSCEMS were included, and 137 of 248 paramedic students completed the questionnaire (55% response rate); 88 students (64.2%) scored >7.5 points, indicating competency in (ECG) interpretation. Factors such as grade point average (GPA) (>3.5) and enrollment in cardiology and advanced cardiac life support courses were found to be significantly associated with competency (p<0.001). Conclusion: The majority of paramedic students were found to be competent in ECG interpretation. GPA and enrollment in cardiology and advanced cardiac life support courses were significantly associated with improved competency.

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“…Data from the Singapore Myocardial Infarction Registry included 4,667 patients with STEMI enrolled from 2010 to 2012 and showed that less than half of STEMI patients (49.8%) utilized EMS transport. Patients who used EMS transport were associated with higher rate of reperfusion therapy and resulted to shorter median symptom onset-to-balloon and door-to-balloon times [ 52 ]. The findings suggest that the STEMI network in Singapore should include programs that educate the community to call the ambulance/EMS using a unique phone number as a mode of transportation to a PCI center when a symptom of heart attack is suspected.…”

Section: Stemi Systems Of Care In Other Low-to-middle-income Countriementioning

confidence: 99%

Comparison of Real-Life Systems of Care for ST-Segment Elevation Myocardial Infarction

Dharma

2020

Global Heart

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The success of ST-segment elevation myocardial infarction (STEMI) networks application in Europe and the United States in delivering rapid reperfusion therapy in the community have become an inspiration to other developing countries to develop regional STEMI network in order to improve the STEMI care. Although barriers are found in the beginning phase of constructing the network, recent analysis from national or regional registries worldwide have shown improvement of the STEMI care in many countries over the years. To improve the overall care of patients with STEMI particularly in developing countries, improvements should be focusing on how to minimize the total ischemia time, and this includes care improvement at each step of care after the patient shows signs and symptoms of chest pain. Innovation in health technology to develop the electrocardiogram transmission and communication system, along with routine performance measures of the STEMI network may help bridging the disparities of STEMI system of care between guideline recommended therapy and the real world clinical practice.

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Emergency Medical Services Utilization among Patients with ST-Segment Elevation Myocardial Infarction: Observations from the Singapore Myocardial Infarction Registry

Abstract: Less than half of STEMI patients utilized EMS and EMS patients had faster receipt of initial reperfusion therapies. Targeted public education to reduce time to treatment may improve the care of STEMI patients.

Cited by 27 publications

References 28 publications

Association of Hospital-Level Differences in Care With Outcomes Among Patients With Acute ST-Segment Elevation Myocardial Infarction in China

Association of Hospital-Level Differences in Care With Outcomes Among Patients With Acute ST-Segment Elevation Myocardial Infarction in China

<p>Electrocardiogram Interpretation Competency Among Paramedic Students</p>

Comparison of Real-Life Systems of Care for ST-Segment Elevation Myocardial Infarction

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