The barriers associated with emergency medical service use for acute coronary syndrome: the awareness and influence of an Australian public mass media campaign

2017 ◽  
Vol 34 (7) ◽  
pp. 466-471
Author(s):  
Susie Cartledge ◽  
Judith Finn ◽  
Lahn Straney ◽  
Phillip Ngu ◽  
Dion Stub ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Service Use ◽  
Tertiary Hospital ◽  
Sudden Onset ◽  
Warning Signs ◽  
Clinical Role ◽  
Factors Associated ◽  
Coronary Syndrome ◽  
Emergency Medical ◽  
Patient Selection Criteria

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.

Abstract 11763: The impact of the Australian Warning Signs Campaign on Emergency Medical Service Use for Acute Coronary Syndrome and Unspecified Chest Pain

Circulation ◽  
2021 ◽  
Vol 144 (Suppl_2) ◽  
Author(s):  
Kathryn J Eastwood ◽  
Stuart Howell ◽  
Ziad Nehme ◽  
Judith Finn ◽  
Karen L Smith ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Chest Pain ◽  
Service Use ◽  
Warning Signs ◽  
Public Hospitals ◽  
Media Campaigns ◽  
Coronary Syndrome ◽  
Emergency Medical ◽  
National Heart Foundation ◽  
The Impact

Background: Between 2009 and 2013, the National Heart Foundation of Australia ran mass media campaigns to improve Australian’s awareness of Acute Coronary Syndrome (ACS) symptoms and the need to call emergency medical services (EMS). This study examined the impact of this campaign on emergency department (ED) presentations and EMS use in Victoria, Australia. Methods: The Victorian Department of Health and Human Services provided data for adult Victorian patients presenting to public hospitals with an ED diagnosis of ACS or unspecified chest pain (U-CP). We modelled changes in the incidence of ED presentations, and the association between the campaign period and 1) EMS arrival and 2) referred to ED by a general practitioner (GP). Models were adjusted for increasing population size, ACS subtype and demographics. Results: Between 2003 and 2015, there were 124,632 eligible ED presentations with ACS and 536,148 with U-CP. In ACS patients, the campaign period was associated with an increase in ED presentations (Incidence Rate Ratio: 1.11; 95% CI: 1.07-1.15), a decrease in presentations via a GP (Adjusted Odds Ratio [AOR]: 0.77; 95% CI: 0.70-0.86), and an increase in EMS use (AOR: 1.10; 95%CI: 1.05-1.17). Similar, but smaller associations were seen in U-CP. Conclusions: The Warning Signs Campaign was associated with improvements in treatment seeking in ACS patients -including increased EMS use. The increase in ACS ED presentations corresponds with a decrease in out-of-hospital cardiac arrest over this time. Future education need to focus on improving EMS use in ACS patient groups where use remains low.

scholarly journals Predicting acute coronary syndrome in males and females with chest pain who call an emergency medical communication centre

2019 ◽  
Vol 27 (1) ◽  
Author(s):  
Paul-Georges Reuter ◽  
Catherine Pradeau ◽  
Samantha Huo Yung Kai ◽  
Thibault Lhermusier ◽  
Arnaud Bourdé ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Chest Pain ◽  
Characteristic Curve ◽  
Validation Dataset ◽  
Medical Communication ◽  
Factors Associated ◽  
Coronary Syndrome ◽  
Emergency Medical ◽  
Lemeshow Test ◽  
Emergency Medical Communication Centre

Abstract Background Chest pain is a frequent reason for calls in emergency medical communication centre (EMCC). Detecting a coronary origin by phone is a challenge. This is especially so as the presentations differ according to gender. We aimed to establish and validate a sex-based model to predict a coronary origin of chest pain in patients calling an EMCC. Methods This prospective cohort study enrolled patients at 18 years of age or older who called the EMCC because of non-traumatic chest pain. The main outcome was the diagnosis of acute coronary syndrome (ACS) determined by expert evaluation of patient files. Results During 18 months, 3727 patients were enrolled: 2097 (56%) men and 1630 (44%) women. ACS was diagnosed in 508 (24%) men and 139 (9%) women. For men, independent factors associated with an ACS diagnosis were age, tobacco use, severe and permanent pain; retrosternal, breathing non-related and radiating pain; and additional symptoms. The area under the receiver operating characteristic curve (AUC) was 0.76 (95% confidence interval [CI] 0.73–0.79) for predicting ACS. The accuracy of the male model to predict ACS was validated in a validation dataset (Hosmer-Lemeshow test: p = 0.554); the AUC was 0.77 (95%CI 0.73–0.80). For women, independent factors associated with an ACS diagnosis were age ≥ 60 years, personal history of coronary artery disease, and breathing non-related and radiating pain. The AUC was 0.79 (95%CI 0.75–0.83). The accuracy of the female model to predict ACS was not validated in the validation dataset (Hosmer-Lemeshow test: p = 0.035); the AUC was 0.67 (95%CI 0.60–0.74). Conclusions Predictors of an ACS diagnosis in patients calling an EMCC for chest pain differ between men and women. We developed an accurate predictive model for men, but for women, the accuracy was poor. Trial registration This study is registered with ClinicalTrials.gov (NCT02042209).

scholarly journals Characteristics, treatment and one-year outcomes of patients with acute coronary syndrome in a tertiary hospital in India

2014 ◽  
Vol 66 (2) ◽  
pp. 156-163 ◽  
Author(s):  
Simeon Isezuo ◽  
Vijayakumar Subban ◽  
Jaishankar Krishnamoorthy ◽  
Ulhas Madhukarrao Pandurangi ◽  
Ezhilan Janakiraman ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Tertiary Hospital ◽  
Coronary Syndrome ◽  
One Year

scholarly journals Pre hospital indicators in assessing the quality of care for patients with acute coronary syndrome

2015 ◽  
Vol 36 (3) ◽  
pp. 49-55
Author(s):  
Gláucia de Souza Omori Maier ◽  
Eleine Aparecida Penha Martins ◽  
Mara Solange Gomes Dellaroza
Keyword(s):  
Acute Coronary Syndrome ◽  
Quality Of Care ◽  
Medical Record ◽  
Heart Attack ◽  
Tertiary Hospital ◽  
Coronary Syndrome ◽  
History Of ◽  
Assess Quality ◽  
Record Review

Objective: to assess quality indicators related to the pre-hospital time for patients with acute coronary syndrome.Method: collection took place at a tertiary hospital in Paraná between 2012 and 2013, through interviews and a medical record review. 94 patients participated, 52.1% male, 78.7% who were over 50 years old, 46.9% studied until the fourth grade, 60.6% were diagnosed with acute myocardial infarction.Results: the outcomes were the time between the onset of symptoms and the decision to seek help with an average of 1022min ± 343.13, door-to-door 805min ± 181.78; and reperfusion, 455min ± 364.8. The choice to seek out care within 60 min occurred in patients who were having a heart attack, and longer than 60 min in those with a history of heart attack or prior catheterization.Conclusion: We concluded that the pre-hospital indicators studied interfered with the quality of care.

scholarly journals Factors Associated with In-hospital Mortality in Patients with Acute Coronary Syndrome

2015 ◽  
Vol 1 (2) ◽  
pp. 68-74 ◽  
Author(s):  
Andreea Barcan ◽  
Istvan Kovacs ◽  
Ciprian Blendea ◽  
Marius Orzan ◽  
Monica Chitu
Keyword(s):  
Myocardial Infarction ◽  
Acute Coronary Syndrome ◽  
Hospital Mortality ◽  
Cardiogenic Shock ◽  
Culprit Lesion ◽  
Left Main ◽  
St Segment Elevation ◽  
Factors Associated ◽  
Coronary Syndrome ◽  
St Segment

Abstract Introduction: The recent development of large networks dedicated to ST-segment elevation myocardial infarction (STEMI) led to a significant increase in the number of primary percutaneous interventions (p-PCI) parallel with mortality reduction in Acute Coronary Syndrome (ACS). The number of non ST segment elevation myocardial infarction (NSTEMI) is increasing and the highest mortality rates are encountered in patients with cardiogenic shock and/or out of hospital cardiac arrest associated to ACS. The aim of this study was to identify the factors associated with a higher mortality rate in a global population with acute coronary syndromes presented in the emergency department of a county clinical hospital which serves as a regional center for a STEMI network. Material and method: This is a retrospective study including 684 patients with acute coronary syndrome admitted in the Clinic of Cardiology from the County Clinical Emergency Hospital Tîrgu Mureș in 2014. In all the cases, the factors that correlated with in hospital mortality were identified and analyzed. Results: The incidence of arterial hypertension was significantly higher in patients admitted with unstable angina (75.0%) and STEMI cases with less than 12 hours onset of symptomatology (68.1%), while impaired renal function correlated with the presence of NSTEMI (66.6%). The presence of a multivessel disease was significantly correlated with cardiogenic shock. The localisation of the culprit lesion in the left anterior descending artery (LAD) significantly correlated with the development of cardiogenic shock, LAD culprit lesions being present in 44.4% of CS cases as compared with 21.7% of noCS cases in STEMI patients. In NSTEMI patients, the localisation of the culprit lesion in the left main artery (LM) significantly correlated with the development of cardiogenic shock, culprit lesions in the left main being present in 47.0% of CS cases as compared with 28.5% of noCS cases in STEMI patients. Conclusion: Patients presenting with out-of-hospital resuscitated cardiac arrest due to Acute Myocardial Infarction associate higher in-hospital mortality rates. In-hospital mortality seems to be highly correlated with the female gender, STEMI myocardial infarction and the presence of multivascular lesions.

scholarly journals Factors associated with study completion in patients with premature acute coronary syndrome

PLoS ONE ◽  
2017 ◽  
Vol 12 (3) ◽  
pp. e0173594
Author(s):  
Anthony W. Austin ◽  
Roxanne Pelletier ◽  
Louise Pilote ◽  
Doreen M. Rabi ◽  
Keyword(s):  
Acute Coronary Syndrome ◽  
Factors Associated ◽  
Coronary Syndrome ◽  
Study Completion
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