BACKGROUND: Empirical evidence suggests that people value emergency medical services (EMS) but that they may not use the service when experiencing chest pain. This study evaluates this phenomenon and the factors associated with the failure to use EMS during a potential cardiac event. METHODS AND RESULTS: Baseline data were gathered from a randomized, controlled community trial (REACT) that was conducted in 20 US communities. A random-digit-dial survey documented bystander intentions to use EMS for cardiac symptoms in each community. An emergency department surveillance system documented the mode of transport among chest pain patients in each community and collected ancillary data, including situational factors surrounding the chest pain event. Logistic regression identified factors associated with failure to use EMS. A total of 962 community members responded to the phone survey, and data were collected on 875 chest pain emergency department arrivals. The mean proportion of community members intending to use EMS during a witnessed cardiac event was 89%; the mean proportion of patients observed using the service was 23%, with significant geographic differences (range, 10% to 48% use). After controlling for covariates, non-EMS users were more likely to try antacids/aspirin and call a doctor and were less likely to subscribe to (or participate in) an EMS prepayment plan. CONCLUSIONS: The results of this study indicate that indecision, self-treatment, physician contact, and financial concerns may undermine a chest pain patient's intention to use EMS.
RCT Entities:
BACKGROUND: Empirical evidence suggests that people value emergency medical services (EMS) but that they may not use the service when experiencing chest pain. This study evaluates this phenomenon and the factors associated with the failure to use EMS during a potential cardiac event. METHODS AND RESULTS: Baseline data were gathered from a randomized, controlled community trial (REACT) that was conducted in 20 US communities. A random-digit-dial survey documented bystander intentions to use EMS for cardiac symptoms in each community. An emergency department surveillance system documented the mode of transport among chest painpatients in each community and collected ancillary data, including situational factors surrounding the chest pain event. Logistic regression identified factors associated with failure to use EMS. A total of 962 community members responded to the phone survey, and data were collected on 875 chest pain emergency department arrivals. The mean proportion of community members intending to use EMS during a witnessed cardiac event was 89%; the mean proportion of patients observed using the service was 23%, with significant geographic differences (range, 10% to 48% use). After controlling for covariates, non-EMS users were more likely to try antacids/aspirin and call a doctor and were less likely to subscribe to (or participate in) an EMS prepayment plan. CONCLUSIONS: The results of this study indicate that indecision, self-treatment, physician contact, and financial concerns may undermine a chest painpatient's intention to use EMS.
Authors: Sameer Mehta; Estefanía Oliveros; Carlos E Alfonso; Esther Falcão; Faisal Shamshad; Ana I Flores; Salomon Cohen Journal: J Saudi Heart Assoc Date: 2009-10
Authors: Elizabeth Barnett Pathak; Michele L Casper; Jean Paul Tanner; Steven Reader; Beverly Ward Journal: Prev Chronic Dis Date: 2010-04-15 Impact factor: 2.830
Authors: Bernd Nowak; Evangelos Giannitsis; Thomas Riemer; Thomas Münzel; Michael Haude; Lars S Maier; Claus Schmitt; Burghard Schumacher; Harald Mudra; Christian Hamm; Jochen Senges; Thomas Voigtländer Journal: Eur Heart J Acute Cardiovasc Care Date: 2012-12
Authors: G Hanania; J-P Cambou; P Guéret; L Vaur; D Blanchard; J-M Lablanche; Y Boutalbi; R Humbert; P Clerson; N Genès; N Danchin Journal: Heart Date: 2004-12 Impact factor: 5.994