Barriers associated with emergency medical service activation in patients with ST-segment elevation acute coronary syndromes.
Barriers
Emergency Medical System
Primary percutaneous coronary intervention
STEACS
Journal
Internal and emergency medicine
ISSN: 1970-9366
Titre abrégé: Intern Emerg Med
Pays: Italy
ID NLM: 101263418
Informations de publication
Date de publication:
06 2022
06 2022
Historique:
received:
04
04
2021
accepted:
13
11
2021
pubmed:
27
11
2021
medline:
31
5
2022
entrez:
26
11
2021
Statut:
ppublish
Résumé
Many ST-segment elevation acute coronary syndrome (STEACS) patients fail to activate the Emergency Medical System (EMS), with possible dramatic consequences. Prior studies focusing on barriers to EMS activation included patients with any acute coronary syndrome (ACS) without representation of southern European populations. We aimed to investigate the barriers to EMS call for patients diagnosed for STEACS in Italy. A prospective, single-center, survey administered to all patients treated with primary percutaneous coronary intervention for STEACS in a tertiary hospital in northern Italy from 01/06/2018 to 31/05/2020. The questionnaire was filled out by 293 patients. Of these, 191 (65.2%) activated the EMS after symptoms onset. The main reasons for failing to contact EMS were the perception that the symptoms were unrelated to an important health problem (45.5%) and that a private vehicle is faster than EMS to reach the hospital (34.7%). Patients who called a private doctor after symptoms onset did not call EMS more frequently than those who did not and 30% of the patients who did not call the EMS would still act in the same way if a new episode occurred. Previous history of cardiovascular disease was the only predictor of EMS call. Information campaigns are urgently needed to increase EMS activation in case of suspected STEACS and should be primary focused on patients without cardiovascular history, on the misperception that a private vehicle is faster than EMS activation, and on the fact that cardiac arrest occurs early and may be prevented by EMS activation.
Identifiants
pubmed: 34826051
doi: 10.1007/s11739-021-02894-7
pii: 10.1007/s11739-021-02894-7
pmc: PMC8616749
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1165-1174Investigateurs
Valeria Crescio
(V)
Irene Raso
(I)
Andrea Demarchi
(A)
Alberto Somaschini
(A)
Stefano Cornara
(S)
Silvana De Martino
(S)
Chiara Gargiulo
(C)
Paolo Bozzini
(P)
Stefano Buratti
(S)
Michela Coccia
(M)
Federico Fortuni
(F)
Ambra Uccello
(A)
Giulia Fini
(G)
Sabato D'Amore
(S)
Davide Foglia
(D)
Marco Rolando
(M)
Arianna Grelli
(A)
Letizia Mannucci
(L)
Lucrezia Masiello
(L)
Matteo Astuti
(M)
Veronica Buia
(V)
Martina Querio Giannetto
(M)
Raniero Covi
(R)
Ciro Di Giacomo
(C)
Laura Frigerio
(L)
Francesco Moretti
(F)
Simonluca Digiacomo
(S)
Laura Pezza
(L)
Matteo Casula
(M)
Vilma Kajana
(V)
Francesca Fabris
(F)
Martina Moschella
(M)
Francesco Jeva
(F)
Claudio Montalto
(C)
Leonardo Pignalosa
(L)
Informations de copyright
© 2021. Società Italiana di Medicina Interna (SIMI).
Références
Widimsky P, Wijns W, Fajadet J et al (2010) Reperfusion therapy for ST elevation acute myocardial infarction in Europe: description of the current situation in 30 countries. Eur Heart J 31(8):943–957. https://doi.org/10.1093/eurheartj/ehp492
doi: 10.1093/eurheartj/ehp492
pubmed: 19933242
Zijlstra F, de Boer MJ, Hoorntje J, Reiffers S, Reiber J, Suryapranata H (1993) A comparison of immediate coronary angioplasty with intravenous streptokinase in acute myocardial infarction. N Engl J Med 328(10):680–684. https://doi.org/10.1056/nejm199303113281002
doi: 10.1056/nejm199303113281002
pubmed: 8433726
Terkelsen CJ, Sørensen JT, Maeng M et al (2010) System delay and mortality among patients with STEMI treated with primary percutaneous coronary intervention. JAMA J Am Med Assoc 304(7):763–771. https://doi.org/10.1001/jama.2010.1139
doi: 10.1001/jama.2010.1139
O’Connor RE, Al Ali AS, Brady WJ et al (2015) Part 9: Acute coronary syndromes: 2015 American Heart Association guidelines update for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation 132(18):S483–S500. https://doi.org/10.1161/CIR.0000000000000263
doi: 10.1161/CIR.0000000000000263
pubmed: 26472997
Ibanez B, James S, Agewall S et al (2018) 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation. Eur Heart J 39(2):119–177. https://doi.org/10.1093/eurheartj/ehx393
doi: 10.1093/eurheartj/ehx393
pubmed: 28886621
Luqman N, Sung RJ, Wang CL, Kuo CT (2007) Myocardial ischemia and ventricular fibrillation: Pathophysiology and clinical implications. Int J Cardiol 119(3):283–290. https://doi.org/10.1016/j.ijcard.2006.09.016
doi: 10.1016/j.ijcard.2006.09.016
pubmed: 17166606
Lettieri C, Savonitto S, De Servi S et al (2009) Emergency percutaneous coronary intervention in patients with ST-elevation myocardial infarction complicated by out-of-hospital cardiac arrest: Early and medium-term outcome. Am Heart J. https://doi.org/10.1016/j.ahj.2008.10.018
doi: 10.1016/j.ahj.2008.10.018
pubmed: 19249431
Kontos MC, Scirica BM, Chen AY et al (2015) Cardiac arrest and clinical characteristics, treatments and outcomes among patients hospitalized with ST-elevation myocardial infarction in contemporary practice: a report from the National Cardiovascular Data Registry. Am Heart J 169(4):515-522.e1. https://doi.org/10.1016/j.ahj.2015.01.010
doi: 10.1016/j.ahj.2015.01.010
pubmed: 25819858
O’Doherty M, Tayler DI, Quinn E, Vincent R, Chamberlain DA (1983) Five hundred patients with myocardial infarction monitored within one hour of symptoms. Br Med J 286(6375):1405–1408. https://doi.org/10.1136/bmj.286.6375.1405
doi: 10.1136/bmj.286.6375.1405
Johansson I, Strömberg A, Swahn E (2004) Ambulance use in patients with acute myocardial infarction. J Cardiovasc Nurs 19(1):5–12. https://doi.org/10.1097/00005082-200401000-00004
doi: 10.1097/00005082-200401000-00004
pubmed: 14994777
Lozzi L, Carstensen S, Rasmussen H, Nelson G (2005) Why do acute myocardial infarction patients not call an ambulance? An interview with patients presenting to hospital with acute myocardial infarction symptoms. Intern Med J 35(11):668–671. https://doi.org/10.1111/j.1445-5994.2005.00957.x
doi: 10.1111/j.1445-5994.2005.00957.x
pubmed: 16248861
Mooney M, O’Brien F, McKee G, O’Donnell S, Moser D (2016) Ambulance use in acute coronary syndrome in Ireland: a cross-sectional study. Eur J Cardiovasc Nurs 15(5):345–354. https://doi.org/10.1177/1474515115579134
doi: 10.1177/1474515115579134
pubmed: 25805100
Thuresson M, Jarlöv MB, Lindahl B, Svensson L, Zedigh C, Herlitz J (2008) Factors that influence the use of ambulance in acute coronary syndrome. Am Heart J 156(1):170–176. https://doi.org/10.1016/j.ahj.2008.01.020
doi: 10.1016/j.ahj.2008.01.020
pubmed: 18585513
Ma J, Wang J, Zheng W et al (2017) Usage of ambulance transport and influencing factors in acute coronary syndrome: a cross-sectional study at a tertiary centre in China. BMJ Open 7(8):1–8. https://doi.org/10.1136/bmjopen-2016-015809
doi: 10.1136/bmjopen-2016-015809
Meischke H, Ho MT, Eisenberg MS, Schaeffer SM, Larsen MP (1995) Reasons patients with chest pain delay or do not call 911. Ann Emerg Med 25(2):193–197. https://doi.org/10.1016/S0196-0644(95)70323-3
doi: 10.1016/S0196-0644(95)70323-3
pubmed: 7832346
Brown AL, Mann NC, Daya M et al (2000) Demographic, belief, and situational factors influencing the decision to utilize emergency medical services among chest pain patients. Circulation 102:173–178
doi: 10.1161/01.CIR.102.2.173
Cartledge S, Finn J, Straney L et al (2017) The barriers associated with emergency medical service use for acute coronary syndrome: the awareness and influence of an Australian public mass media campaign. Emerg Med J 34(7):466–471. https://doi.org/10.1136/emermed-2016-206396
doi: 10.1136/emermed-2016-206396
pubmed: 28289037
Chew KS, Annuar WMWM, Rahman NHNA et al (2015) A survey on the choice of transportation to come to emergency department among patients with acute coronary syndrome of a community in Malaysia. Med J Malaysia 70(1):6–11
pubmed: 26032522
Thang ND, Karlson BW, Bergman B et al (2012) Characteristics of and outcome for patients with chest pain in relation to transport by the emergency medical services in a 20-year perspective. Am J Emerg Med 30(9):1788–1795. https://doi.org/10.1016/j.ajem.2012.02.014
doi: 10.1016/j.ajem.2012.02.014
pubmed: 22633724
Fares S, Zubaid M, Al-Mahmeed W et al (2011) Utilization of emergency medical services by patients with acute coronary syndromes in the Arab Gulf States. J Emerg Med 41(3):310–316. https://doi.org/10.1016/j.jemermed.2010.05.002
doi: 10.1016/j.jemermed.2010.05.002
pubmed: 20580517
Hartford M, Karlson BW, Sjolin M, Holmberg S, Herlitz J (1993) Symptoms, thoughts, and environmental factors in suspected acute myocardial infarction. Heart Lung J Crit Care 22(1):64–70
Moser DK, Kimble LP, Alberts MJ et al (2006) Reducing delay in seeking treatment by patients with acute coronary syndrome and stroke: a scientific statement from the American Heart Association Council on Cardiovascular Nursing and Stroke Council. Circulation 114:168–182. https://doi.org/10.1161/CIRCULATIONAHA.106.176040
doi: 10.1161/CIRCULATIONAHA.106.176040
pubmed: 16801458
Leonardi S, Montalto C, Casella G et al (2020) Clinical governance programme in patients with acute coronary syndrome: design and methodology of a quality improvement initiative. Open Heart. https://doi.org/10.1136/openhrt-2020-001415
doi: 10.1136/openhrt-2020-001415
pubmed: 33372102
pmcid: 7768950
Baldi E, Sechi GM, Mare C et al (2020) COVID-19 kills at home: the close relationship between the epidemic and the increase of out-of-hospital cardiac arrests. Eur Heart J 41(32):3045–3054. https://doi.org/10.1093/eurheartj/ehaa508
doi: 10.1093/eurheartj/ehaa508
pubmed: 32562486
Diercks DB, Kontos MC, Chen AY et al (2009) Utilization and Impact of Pre-Hospital Electrocardiograms for Patients With Acute ST-Segment Elevation Myocardial Infarction. Data From the NCDR (National Cardiovascular Data Registry) ACTION (Acute Coronary Treatment and Intervention Outcomes Network) Registry. J Am Coll Cardiol. 53(2):161–166. https://doi.org/10.1016/j.jacc.2008.09.030
doi: 10.1016/j.jacc.2008.09.030
pubmed: 19130984
Bagai A, Jollis JG, Dauerman HL et al (2013) Emergency department bypass for ST-segment-elevation myocardial infarction patients identified with a prehospital electrocardiogram: a report from the American heart association mission: Lifeline program. Circulation 128(4):352–359. https://doi.org/10.1161/CIRCULATIONAHA.113.002339
doi: 10.1161/CIRCULATIONAHA.113.002339
pubmed: 23788525
Gorenek B, Lundqvist CB, Terradellas JB et al (2015) Cardiac arrhythmias in acute coronary syndromes: position paper from the joint EHRA, ACCA, and EAPCI task force. EuroIntervention 10(9):1095–1108. https://doi.org/10.4244/EIJY14M08_19
doi: 10.4244/EIJY14M08_19
pubmed: 25169596
McKee G, Mooney M, O’Donnell S, O’Brien F, Biddle MJ, Moser DK (2013) Multivariate analysis of predictors of pre-hospital delay in acute coronary syndrome. Int J Cardiol 168(3):2706–2713. https://doi.org/10.1016/j.ijcard.2013.03.022
doi: 10.1016/j.ijcard.2013.03.022
pubmed: 23578888
Bray JE, Stub D, Ngu P et al (2015) Mass media campaigns’ influence on prehospital behavior for acute coronary syndromes: an evaluation of the Australian Heart Foundation’s Warning Signs Campaign. J Am Heart Assoc. https://doi.org/10.1161/JAHA.115.001927
doi: 10.1161/JAHA.115.001927
pubmed: 26150478
pmcid: 4608076
McKinley S, Dracup K, Moser DK et al (2004) International comparison of factors associated with delay in presentation for AMI treatment. Eur J Cardiovasc Nurs 3(3):225–230. https://doi.org/10.1016/j.ejcnurse.2004.06.004
doi: 10.1016/j.ejcnurse.2004.06.004
pubmed: 15350232
Kiguchi T, Okubo M, Nishiyama C et al (2020) Out-of-hospital cardiac arrest across the World: first report from the International Liaison Committee on Resuscitation (ILCOR). Resuscitation 152:39–49. https://doi.org/10.1016/j.resuscitation.2020.02.044
doi: 10.1016/j.resuscitation.2020.02.044
pubmed: 32272235
Lee DW, Moon HJ, Heo NH (2019) Association between ambulance response time and neurologic outcome in patients with cardiac arrest. Am J Emerg Med 37(11):1999–2003. https://doi.org/10.1016/j.ajem.2019.02.021
doi: 10.1016/j.ajem.2019.02.021
pubmed: 30795948
Greif R, Bhanji F, Bigham BL et al (2020) Education, implementation, and teams. Circulation 142(1):S222–S283. https://doi.org/10.1161/CIR.0000000000000896
doi: 10.1161/CIR.0000000000000896
pubmed: 33084395
Guerchicoff A, Brener SJ, Maehara A et al (2014) Impact of delay to reperfusion on reperfusion success, infarct size, and clinical outcomes in patients with St-segment elevation myocardial infarction: the INFUSE-AMI trial (INFUSE-anterior myocardial infarction). JACC Cardiovasc Interv 7(7):733–740. https://doi.org/10.1016/j.jcin.2014.01.166
doi: 10.1016/j.jcin.2014.01.166
pubmed: 25060015
Fordyce CB, Al-Khalidi HR, Jollis JG et al (2017) Association of rapid care process implementation on reperfusion times across multiple ST-segment-elevation myocardial infarction networks. Circ Cardiovasc Interv. https://doi.org/10.1161/CIRCINTERVENTIONS.116.004061
doi: 10.1161/CIRCINTERVENTIONS.116.004061
pubmed: 28082714
pmcid: 6561112
Stowens JC, Sonnad SS, Rosenbaum RA (2015) Using EMS dispatch to trigger STEMI alerts decreases door-to-balloon times. West J Emerg Med 16(3):472–480. https://doi.org/10.5811/westjem.2015.4.24248
doi: 10.5811/westjem.2015.4.24248
pubmed: 25987932
pmcid: 4427229
De Rosa S, Spaccarotella C, Basso C et al (2020) Reduction of hospitalizations for myocardial infarction in Italy in the COVID-19 era. Eur Heart J 41(22):2083–2088. https://doi.org/10.1093/eurheartj/ehaa409
doi: 10.1093/eurheartj/ehaa409
pubmed: 32412631
De Filippo O, D’Ascenzo F, Angelini F et al (2020) Reduced rate of hospital admissions for ACS during Covid-19 outbreak in northern Italy. N Engl J Med 383(1):1–3. https://doi.org/10.1056/NEJMc2009166
doi: 10.1056/NEJMc2009166