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Factors influencing choice of pre‐hospital transportation of patients with potential acute coronary syndrome: A n observational study
Author(s) -
Lavery Tim,
Greenslade Jaimi H,
Parsonage William A,
Hawkins Tracey,
Dalton Emily,
Hammett Christopher,
Cullen Louise
Publication year - 2017
Publication title -
emergency medicine australasia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.602
H-Index - 52
eISSN - 1742-6723
pISSN - 1742-6731
DOI - 10.1111/1742-6723.12735
Subject(s) - medicine , acute coronary syndrome , emergency department , vomiting , nausea , observational study , early warning score , emergency medicine , emergency medical services , medical record , vital signs , medical emergency , myocardial infarction , pediatrics , anesthesia , psychiatry
Objective To determine factors associated with ambulance use in patients with confirmed and potential acute coronary syndrome presenting to the ED. Methods A convenience sample of patients ( n = 247) presenting to the ED from April 2014 to January 2015 with suspected acute coronary syndrome were included in the study. Data on mode of transport and patient demographics were collected from the Emergency Department Information System database. Clinical data were collected from chart records and information systems. A questionnaire assessed reasons for using a chosen method of transport, symptom timing and characteristics, acute coronary syndrome knowledge, and awareness of the National Heart Foundation Early Warning Symptoms campaign. Results Approximately half the patients (49.4%) assessed with symptoms of potential acute coronary syndrome used ambulance transport to the ED. Patients who arrived by ambulance were older than those not arriving by ambulance (mean 56.7 years vs 51.7 years, P = 0.01). Risk factors were not associated with ambulance use. Dizziness ( P < 0.01), sweating ( P = 0.03), nausea ( P = 0.03) and vomiting ( P = 0.04) were associated with increased ambulance use. Mean systolic blood pressure was lower in the ambulance group (136 mmHg, standard deviation [SD] = 19.8) than in the non‐ambulance group (143 mmHg, SD = 25.9). Awareness of the National Heart Foundation Heart Attack Warning Signs campaign was not associated with ambulance use. Conclusions Patients with possible ischaemic symptoms who are at a high risk of cardiac disease do not utilise ambulance services more than low risk patients. In general, transport to hospital using ambulance services by patients with symptoms of possible acute coronary syndrome is low despite community campaigns.