Factors Associated with Emergency Medical Service Use for Acute Coronary Syndrome Patients in Victoria

BackgroundEmergency medical services (EMS) transport to hospital is recommended in acute coronary syndrome (ACS) guidelines, but only half of patients with ACS currently use EMS. The recent Australian Warning Signs campaign conducted by the Heart Foundation addressed some of the known barriers against using EMS. Our aim was to examine the influence of awareness of the campaign on these barriers in patients with ACS.MethodsInterviews were conducted with patients admitted to an Australian tertiary hospital between July 2013 and April 2014 with a diagnosis of ACS. Patient selection criteria included: aged 35–75 years, competent to provide consent, English speaking, not in residential care and medically stable. Multivariable logistic regression was used to examine factors associated with EMS use.ResultsOnly 54% of the 199 patients with ACS interviewed used EMS for transport to hospital. Overall 64% of patients recalled seeing the campaign advertising, but this was not associated with increased EMS use (52.0%vs56.9%, p=0.49) or in the barriers against using EMS. A large proportion of patients (43%) using other transport thought it would be faster. Factors associated with EMS use for ACS were: age >65 years, ST-elevation myocardial infarction, a sudden onset of pain and experiencing vomiting.ConclusionIn medically stable patients with ACS, awareness of the Australian Warning Signs campaign was not associated with increased use of EMS or a change in the barriers for EMS use. Future education strategies could emphasise the clinical role that EMS provide in ACS.

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Geospatial Analysis of Ambulance Station Coverage of the Acute Coronary Syndrome Incidents in Semey, Kazakhstan

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2020.5160 ◽

2020 ◽

Vol 8 (E) ◽

pp. 638-646

Author(s):

Askhat Shaltynov ◽

Askar Abiltaev ◽

Bakytzhan Konabekov ◽

Ulzhan Jamedinova ◽

Daulet Aldyngurov ◽

...

Keyword(s):

Acute Coronary Syndrome ◽

Cardiovascular Diseases ◽

Emergency Medical Service ◽

Medical Service ◽

High Density ◽

National Standard ◽

Left Bank ◽

Coronary Syndrome ◽

Emergency Calls ◽

Emergency Medical

BACKGROUND: One of the main causes of death is cardiovascular diseases. Among cardiovascular diseases ischemic heart disease is major a cause of death. Emergency medical service and ambulance play the key role in providing timely care. AIM: This study was carried out to investigate the coverage area of calls of acute coronary syndrome (ACS) by ambulance stations in regards to the time using GIS-analyze. METHODS: This was descriptive study which contains secondary data from Semey ambulance service’s database about all 1704 ACS with and without elevation of ST segment emergency calls in Semey city (Kazakhstan) over the period from August 1, 2017 to May 30, 2018. Spatial Analyst and Network Analyst Extensions of ArcGIS 10.7 (ESRI, CA, USA) were used to define high ACS density areas and find 10, 15, and 20 min time response areas. Kernel density tool calculates a magnitude-per-unit area from point or polyline features using a kernel function to fit a smoothly tapered surface to each point or polyline. RESULTS: The distance to the patient for ambulances was from 7 to 15 km. For most calls, the response time was <10 min, which is the recommended national standard for emergency care. Density zones were divided into seven categories from white (from 0 to 3.4 cases/km2) to red (from 59.9 to 86.1 cases/km2). The largest high-density area of ACS cases was located in central part of the city on right-bank of the river. Furthermore, high density of ACS cases was identified in the areas of high rise buildings on the left bank of the river. CONCLUSION: GIS tools are useful tool that can be implemented in planning of emergency medical service. In our study, we determined that the service areas of ambulance stations cover the needs of patients with ACS. But nevertheless, it is necessary to plan the ambulance care to nearby regions and villages. In addition, it needs to consider the development of new areas of city and patterns of emergency calls in planning.

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