scholarly journals Demographic, Belief, and Situational Factors Influencing the Decision to Utilize Emergency Medical Services Among Chest Pain Patients

Circulation ◽  
2000 ◽  
Vol 102 (2) ◽  
pp. 173-178 ◽  
Author(s):  
Adam L. Brown ◽  
N. Clay Mann ◽  
Mohamud Daya ◽  
Robert Goldberg ◽  
Hendrika Meischke ◽  
...  
Keyword(s):  
Chest Pain ◽  
Emergency Medical Services ◽  
Situational Factors ◽  
Medical Services ◽  
Factors Influencing ◽  
Emergency Medical ◽  
Pain Patients

scholarly journals Emergency medical services evaluations for chest pain during first COVID-19 lockdown in Hollands-Midden, the Netherlands

2021 ◽  
Vol 29 (4) ◽  
pp. 224-229 ◽  
Author(s):  
E. R. de Koning ◽  
M. J. Boogers ◽  
J. Bosch ◽  
M. de Visser ◽  
M. J. Schalij ◽  
...  
Keyword(s):  
Chest Pain ◽  
Emergency Medical Services ◽  
Medical Services ◽  
Cardiac Symptoms ◽  
Emergency Medical ◽  
Time Period ◽  
Number Of Patients ◽  
St Elevation ◽  
Pain Patients ◽  
Hospital Cardiac Arrest

Abstract Objective To assess whether the COVID-19 lockdown in 2020 had negative indirect health effects, as people seem to have been reluctant to seek medical care. Methods All emergency medical services (EMS) transports for chest pain or out-of-hospital cardiac arrest (OHCA) in the Dutch region Hollands-Midden (population served > 800,000) were evaluated during the initial 6 weeks of the COVID-19 lockdown and during the same time period in 2019. The primary endpoint was the number of evaluated chest pain patients in both cohorts. In addition, the number of EMS evaluations of ST-elevation myocardial infarction (STEMI) and OHCA were assessed. Results During the COVID-19 lockdown period, the EMS evaluated 927 chest pain patients (49% male, age 62 ± 17 years) compared with 1041 patients (51% male, 63 ± 17 years) in the same period in 2019, which corresponded with a significant relative risk (RR) reduction of 0.88 (95% confidence interval (CI) 0.81–0.96). Similarly, there was a significant reduction in the number of STEMI patients (RR 0.52, 95% CI 0.32–0.85), the incidence of OHCA remained unchanged (RR 1.23, 95% CI 0.83–1.83). Conclusion During the first COVID-19 lockdown, there was a significant reduction in the number of patients with chest pain or STEMI evaluated by the EMS, while the incidence of OHCA remained similar. Although the reason for the decrease in chest pain and STEMI consultations is not entirely clear, more attention should be paid to the importance of contacting the EMS in case of suspected cardiac symptoms in possible future lockdowns.

scholarly journals Diurnal, weekly and seasonal variations of chest pain in patients transported by emergency medical services

2019 ◽  
Vol 36 (10) ◽  
pp. 601-607 ◽  
Author(s):  
Ziad Faramand ◽  
Stephanie O Frisch ◽  
Christian Martin-Gill ◽  
Parker Landis ◽  
Mohammad Alrawashdeh ◽  
...  
Keyword(s):  
Chest Pain ◽  
Infarct Size ◽  
Emergency Medical Services ◽  
Independent Predictor ◽  
Healthcare Providers ◽  
Medical Services ◽  
Emergency Medical ◽  
Acute Mi ◽  
St Elevation ◽  
Pain Patients

ObjectivesChest pain is among the leading causes for emergency medical services (EMS) activation. Acute myocardial infarction (MI) is not only one of the most critical aetiologies of chest pain, but also one of few conditions encountered by EMS that has been shown to follow a circadian pattern. Understanding the diurnal relationship between the inflow of chest pain patients and the likelihood of acute MI may inform prehospital and emergency department (ED) healthcare providers regarding the prediction, and hence prevention, of dire outcomes.MethodsThis was a secondary analysis of previously collected data from an observational prospective study that enrolled consecutive chest pain patients transported by a large metropolitan EMS system in the USA. We used the time of EMS call to determine the time-of-day of the indexed encounter. Two independent reviewers examined available medical data to determine our primary outcome, the presence of MI, and our secondary outcomes, infarct size and 30-day major adverse cardiac events (MACE). We estimated infarct size using peak troponin level.ResultsWe enrolled 2065 patients (age 56±17, 53% males, 7.5% with MI). Chest pain encounters increased from 9:00 AM to 2:00 PM, with a peak at 1:00 PM and a nadir at 6:00 AM. Acute MI had a bimodal distribution with two peaks: 10 AM in ST-elevation MI, and 10 PM in non-ST-elevation MI. ST-elevation MI with afternoon onset was an independent predictor of infarct size. Acute MI with winter and early spring presentation was an independent predictor of 30-day MACE.ConclusionsEMS-attended chest pain calls follow a diurnal pattern, with the most vulnerable patients encountered during afternoons and winter/spring seasons. These data can inform prehospital and ED healthcare providers regarding the time of presentation where patients are more likely to have an underlying MI and subsequently worse outcomes.

Triage Ability of Emergency Medical Services Providers and Patient Disposition: A Prospective Study

1999 ◽  
Vol 14 (3) ◽  
pp. 67-72 ◽  
Author(s):  
John R. Richards ◽  
Stephen J. Ferrall
Keyword(s):  
Chest Pain ◽  
Emergency Medical Services ◽  
Patient Characteristics ◽  
University Hospital ◽  
Medical Services ◽  
Shortness Of Breath ◽  
Study Objective ◽  
Patient Disposition ◽  
Emergency Medical ◽  
Respiratory Complaints

AbstractStudy objective:To determine the ability of emergency medical services (EMS) providers to subjectively triage patients with respect to hospital admission and to determine patient characteristics associated with increased likelihood of admission.Methods:A prospective, cross-sectional study of a consecutive sample of patients arriving by ambulance during the month of February 1997 at an urban, university hospital, Emergency Department. Emergency medical services providers completed a questionnaire asking them to predict admission to the hospital and requested patient demographic information. Predictions were compared to actual patient disposition.Results:A total of 887 patients were included in the study, and 315 were admitted to the hospital (36%). With respect to admission, emergency medical services providers had an accuracy rate of 79%, with a sensitivity of 72% and specificity of 83% (kappa = 0.56). Blunt traumatic injury and altered mental status were the most common medical reasons for admission. Variables significantly associated with high admission rates were patients with age > 50 years, chest pain or cardiac complaints, shortness of breath or respiratory complaints, Medicare insurance, and Hispanic ethnicity. The emergency medical services providers most accurately predicted admission for patients presenting with labor (kappa = 1.0), shortness of breath / respiratory complaints (kappa = 0.84), and chest pain (kappa = 0.77).Conclusion:Emergency medical services providers can predict final patient disposition with reasonable accuracy, especially for patients presenting with labor, shortness of breath, or chest pain. Certain patient characteristics are associated with a higher rate of actual admission.

scholarly journals Variation in the Use of 12‐Lead Electrocardiography for Patients With Chest Pain by Emergency Medical Services in North Carolina

2013 ◽  
Vol 2 (4) ◽  
Author(s):  
Montika Bush ◽  
Lawrence T. Glickman ◽  
Antonio R. Fernandez ◽  
J. L. Garvey ◽  
Seth W. Glickman
Keyword(s):  
North Carolina ◽  
Chest Pain ◽  
Emergency Medical Services ◽  
Medical Services ◽  
Emergency Medical

Emergency Medical Services Time Intervals for Acute Chest Pain in the United States, 2015–2016

2019 ◽  
Vol 24 (4) ◽  
pp. 557-565 ◽  
Author(s):  
Eric R. Cui ◽  
Alexandra Beja-Glasser ◽  
Antonio R. Fernandez ◽  
Joseph M. Grover ◽  
N. Clay Mann ◽  
...  
Keyword(s):  
United States ◽  
Chest Pain ◽  
Emergency Medical Services ◽  
Acute Chest Pain ◽  
The United States ◽  
Medical Services ◽  
Time Intervals ◽  
Emergency Medical

scholarly journals Pre-hospital management of patients with chest pain and/or dyspnoea of cardiac origin. A position paper of the Acute Cardiovascular Care Association (ACCA) of the ESC.

2015 ◽  
Vol 9 (1_suppl) ◽  
pp. 59-81 ◽  
Author(s):  
Farzin Beygui ◽  
Maaret Castren ◽  
Natale Daniele Brunetti ◽  
Fernando Rosell-Ortiz ◽  
Michael Christ ◽  
...  
Keyword(s):  
Chest Pain ◽  
Emergency Medical Services ◽  
Hospital Management ◽  
Position Paper ◽  
Medical Services ◽  
Initial Assessment ◽  
Hospital Treatment ◽  
Emergency Medical ◽  
Acute Dyspnoea ◽  
Cardiovascular Care

Chest pain and acute dyspnoea are frequent causes of emergency medical services activation. The pre-hospital management of these conditions is heterogeneous across different regions of the world and Europe, as a consequence of the variety of emergency medical services and absence of specific practical guidelines. This position paper focuses on the practical aspects of the pre-hospital treatment on board and transfer of patients taken in charge by emergency medical services for chest pain and dyspnoea of suspected cardiac aetiology after the initial assessment and diagnostic work-up. The objective of the paper is to provide guidance, based on evidence, where available, or on experts’ opinions, for all emergency medical services’ health providers involved in the pre-hospital management of acute cardiovascular care.

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