Patients with chest pain calling 9-1-1 or self-transporting to reach definitive care: which mode is quicker?

Hutchings, Caroline; Mann, N. Clay; Daya, Mohamud; Jui, Jon; Goldberg, Robert J.; Cooper, Lawton S.; Goff, David C.; Cornell, Carol E.

doi:10.1016/s0002-8703(03)00510-6

Cited by 75 publications

(55 citation statements)

References 17 publications

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“…62,65,66 Patients with possible ischemic symptoms should be transported to the hospital by ambulance rather than by friends or relatives because 1) 1 in every 300 patients with chest pain transported to the emergency department (ED) by private vehicle suffers cardiac arrest en route 67 ; and 2) there is a significant association between arrival at the ED by ambulance and earlier delivery of reperfusion therapy. [64][65][66]68 In addition, the performance of prehospital ECGs by trained personnel is associated with shorter reperfusion times 69 and lower mortality rates from STEMI. The use of prehospital ECGs, particularly when coupled with communication of STEMI diagnosis and preferential transport to a PCI-capable hospital, has been shown to result in rapid reperfusion times and excellent clinical outcomes.…”

Section: Mode Of Transport To the Hospitalmentioning

confidence: 99%

2013 ACCF/AHA Guideline for the Management of ST-Elevation Myocardial Infarction

O’Gara¹,

Kushner²,

Ascheim³

et al. 2013

Circulation

2,515

930

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Section: Mode Of Transport To the Hospitalmentioning

confidence: 99%

2013 ACCF/AHA Guideline for the Management of ST-Elevation Myocardial Infarction

O’Gara¹,

Kushner²,

Ascheim³

et al. 2013

Circulation

2,515

930

View full text Add to dashboard Cite

“…If one considers that initial antiischemic treatment is often delivered by EMS, then EMS use would certainly lead to shorter delays to medical contact and treatment. 19,20 The magnitude of our findings is even more striking when they are considered in the context of the impact made by recent national campaigns to improve STEMI systems of care (eg, the Door-to-Balloon campaign was associated with a 14-minute reduction in door-to-balloon times). 21 Furthermore, use of EMS transport was associated with expedited in-hospital STEMI care.…”

Section: Impact On Process Of Care Measuresmentioning

confidence: 84%

Use of Emergency Medical Service Transport Among Patients With ST-Segment–Elevation Myocardial Infarction

et al. 2011

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Background-Activation of emergency medical services (EMS) is critical for the early triage and treatment of patients experiencing ST-segment-elevation myocardial infarction, yet data regarding EMS use and its association with subsequent clinical care are limited. Methods and Results-We performed an observational analysis of 37 634 ST-segment-elevation myocardial infarction patients treated at 372 US hospitals participating in the National Cardiovascular Data Registry Acute Coronary Treatment and Intervention Outcomes Network Registry-Get With the Guidelines between January 2007 and September 2009, and examined independent patient factors associated with EMS transportation versus patient self-transportation. We found that EMS transport was used in only 60% of ST-segment-elevation myocardial infarction patients. Older patients, those living farther from the hospital, and those with hemodynamic compromise were more likely to use EMS transport. In contrast, race, income, and education level did not appear to be associated with the mode of transport.

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“…84,106 Deference toward physicians causes delays when symptoms occur during off hours. 90,107 Persons who call a physician are less likely to use EMS. 108 Patients who use EMS receive reperfusion therapy faster than those who do not.…”

mentioning

confidence: 99%

Reducing Delay in Seeking Treatment by Patients With Acute Coronary Syndrome and Stroke

Moser¹,

et al. 2006

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Abstract-Patient delay in seeking treatment for acute coronary syndrome and stroke symptoms is the major factor limiting delivery of definitive treatment in these conditions. Despite decades of research and public education campaigns aimed at decreasing patient delay times, most patients still do not seek treatment in a timely manner. In this scientific statement, we summarize the evidence that (1) demonstrates the benefits of early treatment, (2) describes the extent of the problem of patient delay, (3) identifies the factors related to patient delay in seeking timely treatment, and (4) reveals the inadequacies of our current approaches to decreasing patient delay. Finally, we offer suggestions for clinical practice and future research. Key Words: AHA Scientific Statements Ⅲ acute coronary syndrome Ⅲ stroke Ⅲ delivery of health care D espite major advances in identifying effective treatments for heart attack and stroke, there are substantial difficulties in applying these treatments to care. The weak link in the chain of events leading to prompt and effective treatment is patient delay in seeking care. More than 50% of the 1.2 million people who suffer an acute myocardial infarction (AMI) or coronary death each year in the United States die in an emergency department (ED) or before reaching a hospital within an hour of symptom onset. 1 About 700 000 individuals will have a stroke each year, 167 000 of those who have strokes will die, and more will suffer a major disability. 1 Of the stroke deaths that occur each year, almost half occur before the patient reaches the hospital. 2 Many of these deaths and significant disability could be prevented if patients received earlier treatment. 1,3 Although the benefits of early treatment of heart attack and stroke are clear, only a minority of eligible patients receive optimally timed treatment for their symptoms because of delay in seeking care. The development and use of appropriate interventions to decrease treatment-seeking delay by patients could produce important gains in reducing death and disability from heart attack and stroke. Unfortunately, efforts to date to develop effective interventions have met with disappointing results. 4 -6 Accordingly, the purpose of this statement is to summarize the evidence that demonstrates the benefits of early treatment, 1,2 describes the extent of the problem of patient delay, 3 identifies the factors related to patient delay in seeking timely treatment, and reveals the inadequacies of our current approaches to decreasing patient delay. 4 Finally, we offer suggestions for clinical practice and future research. Benefits of Early TreatmentThe burden of cardiovascular disease is growing worldwide. Ischemic heart disease is the No. 1 cause of death in the The findings and conclusions in this scientific statement are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention and the National Heart, Lung, and Blood Institute.The American Heart Association makes every effort to av...

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Patients with chest pain calling 9-1-1 or self-transporting to reach definitive care: which mode is quicker?

Cited by 75 publications

References 17 publications

2013 ACCF/AHA Guideline for the Management of ST-Elevation Myocardial Infarction

2013 ACCF/AHA Guideline for the Management of ST-Elevation Myocardial Infarction

Use of Emergency Medical Service Transport Among Patients With ST-Segment–Elevation Myocardial Infarction

Reducing Delay in Seeking Treatment by Patients With Acute Coronary Syndrome and Stroke

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