Factors influencing choice of pre-hospital transportation of patients with potential acute coronary syndrome: an observational study

Lavery, Tim, Greenslade, Jaimi H., Parsonage, William A., Hawkins, Tracey, Dalton, Emily, Hammett, Christopher and Cullen, Louise (2017) Factors influencing choice of pre-hospital transportation of patients with potential acute coronary syndrome: an observational study. Emergency Medicine Australasia, 29 2: 210-216. doi:10.1111/1742-6723.12735


Author Lavery, Tim
Greenslade, Jaimi H.
Parsonage, William A.
Hawkins, Tracey
Dalton, Emily
Hammett, Christopher
Cullen, Louise
Title Factors influencing choice of pre-hospital transportation of patients with potential acute coronary syndrome: an observational study
Journal name Emergency Medicine Australasia   Check publisher's open access policy
ISSN 1742-6731
1742-6723
Publication date 2017-04-01
Sub-type Article (original research)
DOI 10.1111/1742-6723.12735
Open Access Status Not yet assessed
Volume 29
Issue 2
Start page 210
End page 216
Total pages 7
Place of publication Richmond, VIC, Australia
Publisher Wiley-Blackwell Publishing Asia
Language eng
Abstract To determine factors associated with ambulance use in patients with confirmed and potential acute coronary syndrome presenting to the ED.

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.

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.

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.
Formatted abstract
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.
Keyword Chest pain
Emergency department
Health education
Myocardial ischaemia
Transportation of patient
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

 
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