Utilization of Emergency Medical Services by Patients with Acute Coronary Syndromes in the Arab Gulf States

Fares, Saleh; Zubaid, Mohammad; Almahmeed, Wael; Ciottone, Gregory R.; Sayah, Assaad; Suwaidi, Jassim Al; Amin, Haitham; Al-Atawna, Farid; Ridha, Mustafa; Sulaiman, Kadhim; Alsheikh‐Ali, Alawi A.

doi:10.1016/j.jemermed.2010.05.002

Cited by 28 publications

(36 citation statements)

References 28 publications

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“…Fares and colleagues [29] reported that the use of EMS by only 17% of patients with acute coronary syndromes was shown to be lowest in the region compared with 23% in Bahrain, 30% in Qatar, and 37% in Oman.…”

Section: Methods and Discussionmentioning

confidence: 99%

Emergency medicine in the United Arab Emirates

et al. 2014

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It has been a decade since emergency medicine was recognized as a specialty in the United Arab Emirates (UAE). In this short time, emergency medicine has established itself and developed rapidly in the UAE. Large, well-equipped emergency departments (EDs) are usually located in government hospitals, some of which function as regional trauma centers. Most of the larger EDs are staffed with medically or surgically trained physicians, with board-certified emergency medicine physicians serving as consultants overseeing care.Prehospital care and emergency medical services (EMS) operate under the auspices of the police department. Standardized protocols have been established for paramedic certification, triage, and destination decisions. The majority of ambulances offer basic life support (BLS/Type 2) with a growing minority offering advanced life support (ALS/Type 3).Medicine residency programs were established 5 years ago and form the foundation for training emergency medicine specialists for UAE.This article describes the full spectrum of emergency medicine in the UAE: prehospital care, EMS, hospital-based emergency care, training in emergency medicine, and disaster preparedness. We hope that our experience, our understanding of the challenges faced by the specialty, and the anticipated future directions will be of importance to others advancing emergency medicine in their region and across the globe.

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Section: Methods and Discussionmentioning

confidence: 99%

Emergency medicine in the United Arab Emirates

et al. 2014

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“…Acute coronary syndrome (ACS) is a leading cause of morbidity and mortality worldwide,1 with approximately half of these deaths occurring in the prehospital setting 2. For patients presenting with ST-elevation myocardial infarction (STEMI), percutaneous coronary intervention (PCI) is recommended 3.…”

Section: Introductionmentioning

confidence: 99%

Outcomes by Mode of Transport of ST Elevation MI Patients in the United Arab Emirates

Callachan

Alsheikh‐Ali

Nair

et al. 2017

WestJEM

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IntroductionThe purpose of this multicenter study was to assess differences in demographics, medical history, treatment times, and follow-up status among patients with ST-elevation myocardial infarction (STEMI), who were transported to the hospital by emergency medical services (EMS) or by private vehicle, or were transferred from other medical facilities.MethodsThis multicenter study involved the collection of both retrospective and prospective data from 455 patients admitted to four hospitals in Abu Dhabi. We collected electronic medical records from EMS and hospitals, and conducted interviews with patients in person or via telephone. Chi-square tests and Kruskal–Wallis tests were used to examine differences in variables by mode of transportation.ResultsResults indicated significant differences in modes of transportation when considering symptom-onset-to-balloon time (p < 0.001), door-to-balloon time (p < 0.001), and health status at six-month and one-year follow-up (p < 0.001). Median times (interquartile range) for patients transported by EMS, private vehicle, or transferred from an outside facility were as follows: symptom-onset-to-balloon time in hours, 3.1 (1.8–4.3), 3.2 (2.1–5.3), and 4.5 (3.0–7.5), respectively; door-to-balloon time in minutes, 70 (48–78), 81 (64–105), and 62 (46–77), respectively. In all cases, EMS transportation was associated with a shorter time to treatment than other modes of transportation. However, the EMS group experienced greater rates of in-hospital events, including cardiac arrest and mortality, than the private transport group.ConclusionOur results contribute data supporting EMS transportation for patients with acute coronary syndrome. Although a lack of follow-up data made it difficult to draw conclusions about long-term outcomes, our findings clearly indicate that EMS transportation can speed time to treatment, including time to balloon inflation, potentially reducing readmission and adverse events. We conclude that future efforts should focus on encouraging the use of EMS and improving transfer practices. Such efforts could improve outcomes for patients presenting with STEMI.

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“…Approximately one-half of ACS-related deaths occur in the prehospital period (Fares et al, 2011). Although effects of medical therapies on mortality and morbidity in ACS is inversely related to prehospital delay, the time between symptoms onset and hospital arrival, prehospital delay time remains unreasonably long (Fares et al, 2011;Walsh et al, 2004).…”

Section: Introductionmentioning

confidence: 99%

The significance of cognitive representations of symptoms of acute coronary syndrome and coping responses to the symptoms in predicting prehospital delay in Omani patients

Al‐Hassan

2012

Journal of Research in Nursing

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The purpose of this study was to examine the significance of cognitive representations of symptoms of acute coronary syndrome (ACS) and coping responses to the symptoms, as elements of a consequential process of health care seeking behaviours, in predicting prehospital delay. Data about prehospital delay, cognitive representations and coping responses were obtained from 112 Omani patients hospitalised for acute coronary syndrome during a 6-month period using an interview technique. Indicators of cognitive representations of symptoms of ACS and coping responses to the symptoms significantly explained 42% of the variance in prehospital delay. Shorter prehospital delay was more likely among patients who reported greater chest pain intensity, sweating, persistent symptoms with greater overall intensity, did not perceive fear of being diagnosed with a dangerous disease as a barrier to seek care early, used 'asked someone to take me to the hospital' but not 'attempted to relax' coping responses. Indicators of cognitive representations of ACS symptoms, as well as coping responses to the symptoms significantly predicted prehospital delay. Educative-counseling programs to shorten prehospital delay should focus on informing individuals at high risk for acute coronary syndrome skills necessary to promote adaptive coping as well as accurate interpretation of the symptoms.

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Utilization of Emergency Medical Services by Patients with Acute Coronary Syndromes in the Arab Gulf States

Cited by 28 publications

References 28 publications

Emergency medicine in the United Arab Emirates

Emergency medicine in the United Arab Emirates

Outcomes by Mode of Transport of ST Elevation MI Patients in the United Arab Emirates

The significance of cognitive representations of symptoms of acute coronary syndrome and coping responses to the symptoms in predicting prehospital delay in Omani patients

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