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Patients with STEMI in rural areas treated faster if they call 911, use EMS
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Study results of patients with STEMI in rural areas found that they were treated faster if they called 911 and arrived to a PCI-capable hospital via emergency medical services than if they arrived via personally owned vehicle.
Researchers analyzed data from 774 patients with STEMI who arrived between the third quarter of 2013 and the second quarter of 2014 at 19 hospitals in Minnesota, North Dakota and South Dakota that participated in Mission: Lifeline, an American Heart Association initiative to improve STEMI systems.
John M. Gallagher, MD, and colleagues compared time from arrival at a PCI-capable center to cath lab and time from hospital arrival to PCI between those who arrived via their own vehicles (52%) and those who arrived via emergency medical services (EMS; 48%).
Patients arriving via EMS had a faster time from arrival at a PCI-capable center to arrival at cath lab (mean, 26 minutes; median, 22 to 31 minutes) compared with patients arriving via personally owned vehicle (mean, 38 minutes; median, 35 to 41 minutes).
In addition, mean time from hospital arrival to PCI was faster for those arriving via EMS compared with those arriving via personally owned vehicle (41.5 minutes vs. 56.5 minutes). The difference was observed in all states (Minnesota, 38 minutes vs. 56 minutes; North Dakota, 39.5 minutes vs. 54.5 minutes; South Dakota, 47 minutes vs. 59 minutes), according to the researchers.
“The biggest implication is raising awareness so the public understands the vital role of EMS in health care,” Gallagher, medical director of Winona Area Ambulance Service in Winona, Minnesota, said in a press release. “EMS continues to be viewed as only a ‘ride,’ but utilizing EMS as part of the health care system not only allows for treatment from the time they arrive at your door, but has also been proven to shorten time to reperfusion treatment faster. The public needs to start seeing EMS as the first access point to health care. EMS providers have a plan in place for inclement weather and travel conditions. Their unique capabilities to deliver lifesaving care en route to the hospital should not be underestimated. The benefits of 20 minutes saved in their heart attack timeline are huge.”
This abstract was originally prepared for presentation at the American Heart Association’s Quality of Care and Outcomes Research Scientific Sessions, which was cancelled due to protests and an ongoing state of emergency in Baltimore. – by Erik Swain
Disclosure: Gallagher reports no relevant financial disclosures.
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