Barriers to the use of emergency medical services for ST-elevation myocardial infarction: Determining why many patients opt for self-transport

2017 ◽  
Vol 24 (2) ◽  
pp. 375-379
Author(s):  
Mathew Mercuri ◽  
Katherine Connolly ◽  
Madhu K. Natarajan ◽  
Michelle Welsford ◽  
JD Schwalm
Keyword(s):  
Myocardial Infarction ◽  
Emergency Medical Services ◽  
St Elevation Myocardial Infarction ◽  
Medical Services ◽  
Emergency Medical ◽  
St Elevation

Factors influencing patient decision delay in activation of emergency medical services for suspected ST-elevation myocardial infarction

2020 ◽  
pp. 147451512095373
Author(s):  
Ahmad Alrawashdeh ◽  
Ziad Nehme ◽  
Brett Williams ◽  
Karen Smith ◽  
Michael Stephenson ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Emergency Medical Services ◽  
Symptom Onset ◽  
St Elevation Myocardial Infarction ◽  
Medical Services ◽  
Factors Associated ◽  
Emergency Medical ◽  
History Of ◽  
St Elevation ◽  
At Home

Objective: The purpose of this study was to identify factors associated with time delay to emergency medical services for patients with suspected ST-elevation myocardial infarction. Methods: This observational study involved 1994 suspected ST-elevation myocardial infarction patients presenting to the emergency medical services in Melbourne, Australia, between October 2011–January 2014. Factors associated with delays to emergency medical services call of >1 h and emergency medical services self-referral were analyzed using multivariable logistic regression. Results: The time of symptom onset was reported for 1819 patients (91.2%), the median symptom onset-to-call time was 52 min (interquartile range=17–176). Of all emergency medical services calls, 17% were referred by healthcare professionals. Compared to self-referred patients, patients who presented to a general practitioner or hospital had higher odds of delay >1 h to emergency medical services activation (adjusted odds ratio 7.76; 95% confidence interval 5.10–11.83; and 8.02; 3.65–17.64, respectively). The other factors associated with emergency medical services call delays of >1 h were living alone, non-English speaking background, a history of substance abuse, less severe symptoms, symptom onset at home and at rest, and self-treatment. Emergency medical services self-referred patients were more likely to be older than 75 years, have a history of ischemic heart disease or revascularization, more severe symptoms, and symptom onset at home, with activity, during the weekends and out-of-hours. Conclusion: Almost one-fifth of emergency medical services calls for suspected ST-elevation myocardial infarction were healthcare referrals, and this was associated with increased delays. A wide range of factors could influence a patient’s decision to directly and rapidly seek emergency medical services. More efforts are needed to educate at-risk populations about early self-referral to the emergency medical services.

Emergency Medical Services as a Strategy for Improving ST-Elevation Myocardial Infarction System Treatment Times

2014 ◽  
Vol 46 (3) ◽  
pp. 355-362 ◽  
Author(s):  
James R. Langabeer ◽  
Jami DelliFraine ◽  
Raymond Fowler ◽  
James G. Jollis ◽  
Leilani Stuart ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Emergency Medical Services ◽  
St Elevation Myocardial Infarction ◽  
Medical Services ◽  
Emergency Medical ◽  
St Elevation

Emergency Medical Services Management of ST-Elevation Myocardial Infarction

2008 ◽  
Vol 12 (3) ◽  
pp. 395-403 ◽  
Author(s):  
Michael G. Millin ◽  
Steven C. Brooks ◽  
Andrew Travers ◽  
Ross E. Megargel ◽  
M. Riccardo Colella ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Emergency Medical Services ◽  
St Elevation Myocardial Infarction ◽  
Medical Services ◽  
Emergency Medical ◽  
St Elevation

Use of Emergency Medical Services by Patients with ST-Elevation Myocardial Infarction in a Regional Network

2007 ◽  
Vol 14 (5 Supplement 1) ◽  
pp. S23-S23 ◽  
Author(s):  
K. Menssen ◽  
T. Henry ◽  
B. Unger ◽  
J. Oelfke ◽  
C. Kapsner ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Emergency Medical Services ◽  
St Elevation Myocardial Infarction ◽  
Medical Services ◽  
Regional Network ◽  
Emergency Medical ◽  
St Elevation
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