Predictors of emergency medical services use by adults with heart failure; 2009–2017

Pressler, Susan J.; Jung, Miyeon; Lee, Christopher S.; Arkins, Thomas; O’Donnell, Daniel; Cook, Ryan; Bakoyannis, Giorgos; Newhouse, Robin; Gradus‐Pizlo, Irmina; Pang, Peter S.

doi:10.1016/j.hrtlng.2020.03.002

Cited by 4 publications

(50 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In the parent study, "feeling sick" was the second most frequent chief complaint recorded in the EMS electronic health records for patients with HF (23% of the 16 905 transports). 9 In the current study, similar nonspecific reasons for 911 calls were found but in only 5.5% of callers, such as "feeling bad" or "hurts all over." In addition, changes that may not be connected to a specific health condition were reported in the 911 calls including mobility issues (eg, can't move or get up), feels faint, sweaty/clammy, and emotional discomfort (eg, anxious, agitated, upset), which were not captured in the chief complaints.…”

Section: Discussionsupporting

confidence: 71%

“…The difference suggests that breathing problems are particularly common among persons with HF who requested for EMS activation. Chest pain was frequently reported in both the parent and current studies at similar rates (17.0% in the parent study 9 and 18.3% in the current study). These consistent results may imply that helping the patients and family members to recognize the changes in heart conditions (symptoms, signs, and risks of the events [eg, dizziness before falls]) early in their occurrence may prevent the frightening experiences as they become more severe.…”

Section: Discussionsupporting

confidence: 63%

“…9 In the parent study, respiratory problems were the most frequent chief complaint (26.6%). 9 Similarly, in the study reported here, breathing problems were the most frequent symptom but more frequently mentioned during the 911 calls (55.4%). The difference suggests that breathing problems are particularly common among persons with HF who requested for EMS activation.…”

Section: Discussionmentioning

confidence: 94%

“…The data were retrieved as part of a parent study conducted to characterize prehospital clinical status of adults with reported HF and evaluate predictors of EMS transports to acute care hospitals. 9 Data were retrieved from a large urban EMS system in the Midwest recorded between 2009 and 2017. The database and the methods used for retrieving the data are described in more detail elsewhere.…”

Section: Data Sourcementioning

confidence: 99%

“…There are a number of reasons that patients with HF activate EMS. In a study among 6582 patients with HF who were transported by EMS to hospitals, there were 28 chief complaints recorded in the EMS electronic health system for activating 911 including respiratory problems, feeling sick, pain (chest, abdominal, generalized, back pain, and headache), trauma/injuries, altered mental status or unresponsive, syncope, bleeding (nontraumatic), diabetic emergency, behavioral changes, stroke or transient ischemic attack, nausea/vomiting, seizures/convulsions, poisoning/medication overdose, cardiac arrest, fever or flulike symptoms, allergic reaction, and assault 9 . The study provided new insights on chief complaints and treatments received during the EMS transports among patients with HF.…”

mentioning

confidence: 99%

See 4 more Smart Citations

911 Calls for Emergency Medical Services in Heart Failure

et al. 2022

Self Cite

View full text Add to dashboard Cite

BackgroundHeart failure (HF) is a common condition leading to activation of emergency medical services (EMS).ObjectiveThe aim of this study was to describe reasons given by persons with HF, family members, or other caregivers for requesting EMS activation during 911 calls.MethodsIn this descriptive qualitative study, a content analysis was performed on transcribed audio files of 383 EMS requests involving 383 persons with HF in the community.ResultsOne hundred forty-seven calls (38.4%) were placed by the family members, 75 (19.6%) were placed by the patients, 56 (14.6%) were placed by healthcare workers or personnel from living facilities, and the remaining calls (n = 105, 27.4%) were placed by others (eg, friends, neighbors, officers). Three broad categories of symptoms, signs, and events were identified as the reasons for an EMS request. Frequently reported symptoms were breathing problems (55.4%), chest pain (18.3%), and other pain (eg, head, extremities) (16.7%). Signs included decreased consciousness (15.4%), swelling (5.7%), and bleeding (5.0%). The reported events involved falls (8.1%), heart attack (6.3%), hypoxic episodes (6.0%), stroke (5.2%), and post–hospital-discharge complications (4.7%). In most calls (74.9%), multiple reasons were reported and a combination of symptoms, signs, and events were identified. Heart failure diagnosis was mentioned in fewer than 10% of the calls.ConclusionsOverall, symptoms and signs of HF exacerbation were common reasons to activate 911 calls. Falls were frequently reported. Under the duress of the emergent situations surrounding the 911 call, callers rarely mentioned the existence of HF. Interventions are needed to guide patients with HF and their family members to promote the management of HF to reduce EMS activation as well as to activate EMS quickly for acute changes in HF conditions.

show abstract

Section: Discussionsupporting

confidence: 71%

Section: Discussionsupporting

confidence: 63%

Section: Discussionmentioning

confidence: 94%

Section: Data Sourcementioning

confidence: 99%

mentioning

confidence: 99%

See 3 more Smart Citations

911 Calls for Emergency Medical Services in Heart Failure

et al. 2022

Self Cite

View full text Add to dashboard Cite

show abstract

Characterizing Pain Leading to Emergency Medical Services Activation in Heart Failure

et al. 2021

Self Cite

View full text Add to dashboard Cite

Background: Pain is a common but understudied symptom among patients with heart failure (HF) transported by emergency medical services (EMS). The aims were to determine explanatory factors of a primary complaint of pain and pain severity, and characterize pain among patients with HF transported by EMS. Methods: Data from electronic health records of patients with HF transported by EMS within a midwestern United States county from 2009 to 2017 were analyzed. Descriptive statistics, χ 2 , analysis of variance, and logistic and multiple linear regression analyses were used. Results: The sample (N = 4663) was predominantly women (58.1%) with self-reported race as Black (57.7%). The mean age was 64.2 ± 14.3 years. Pain was the primary complaint in 22.2% of the sample, with an average pain score of 6.8 ± 3.1 out of 10. The most common pain complaint was chest pain (68.1%). Factors associated with a primary pain complaint were younger age (odds ratio [OR], 0.97; 95% confidence interval [CI], 0.96-0.97), history of myocardial infarction (OR, 1.96; 95% CI, 1.55-2.49), and absence of shortness of breath (OR, 0.67; 95% CI, 0.58-0.77). Factors associated with higher pain severity were younger age (b = −0.05, SE = 0.013), being a woman (b = 1.17, SE = 0.357), and White race (b = −1.11, SE = 0.349). Conclusions: Clinical and demographic factors need consideration in understanding pain in HF during EMS transport. Additional research is needed to examine these factors to improve pain management and reduce transports due to pain.

show abstract

A Systematic Literature Review of Hispanic Adults’ Experiences With the Emergency Medical Services System in the United States Between 2000 and 2021

et al. 2023

View full text Add to dashboard Cite

Objective: This systematic literature review presents an overview of studies that assess the experiences of Hispanic adults with (1) activation of emergency medical services (EMS); (2) on-scene care provided by EMS personnel; (3) mode of transport (EMS vs. non-EMS) to an emergency department (ED); and (4) experiences with EMS before and during the COVID-19 pandemic. Methods: A bibliographic database search was conducted to identify relevant studies on Ovid MEDLINE (PubMed), Web of Science, EMBASE, and CINAHL. Quantitative, mixed methods, and qualitative studies published in English or Spanish were included if they discussed Hispanic adults’ experiences with EMS in the US between January 1, 2000 and December 31, 2021. The Hawker and colleagues quality assessment instrument was used to evaluate the quality of studies. Results: Of the 43 included studies, 13 examined EMS activation, 13 assessed on-scene care, 22 discussed the mode of transport to an ED, and 4 described Hispanic adults’ experiences with EMS during the COVID-19 pandemic. Hispanics were less likely to activate EMS (N=7), less likely to receive certain types of on-scene care (N=6), and less likely to use EMS as the mode of transport to an ED (N=13), compared with non-Hispanic Whites. During the early COVID-19 pandemic period (March to May 2020), EMS use decreased by 26.5% compared with the same months during the previous 4 years. Conclusions: The contribution of this study is its attention to Hispanic adults’ experiences with the different phases of the US EMS system.

show abstract

Predictors of emergency medical services use by adults with heart failure; 2009–2017

Cited by 4 publications

References 36 publications

911 Calls for Emergency Medical Services in Heart Failure

911 Calls for Emergency Medical Services in Heart Failure

Characterizing Pain Leading to Emergency Medical Services Activation in Heart Failure

A Systematic Literature Review of Hispanic Adults’ Experiences With the Emergency Medical Services System in the United States Between 2000 and 2021

Contact Info

Product

Resources

About