Why do acute myocardial infarction patients not call an ambulance? An interview with patients presenting to hospital with acute myocardial infarction symptoms

• Published in: Internal medicine journal Vol. 35; no. 11; pp. 668 - 671
• Main Authors: Lozzi, L., Carstensen, S., Rasmussen, H., Nelson, G.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Science Pty 01.11.2005; Blackwell Science
• Subjects: acute myocardial infarction; ambulance; Ambulances - utilization; Australia; Biological and medical sciences; Cardiology. Vascular system; Coronary heart disease; Decision Making; Emergency Medical Services - utilization; Female; General aspects; general practitioner; Health Education; Health Knowledge, Attitudes, Practice; Heart; Humans; Interviews as Topic; Male; Medical sciences; Middle Aged; Myocardial Infarction - diagnosis; Myocardial Infarction - epidemiology; Myocardial Infarction - therapy; Patient Acceptance of Health Care - statistics & numerical data; Patient Admission - statistics & numerical data; Prevalence; Severity of Illness Index; Surveys and Questionnaires; symptoms; Australia; Human; Myocardial infarction; General practitioner; Acute; Cardiovascular disease; Patient; Myocardial disease; Interview; Medicine; symptoms; Symptomatology; Ambulance; Heart disease; Hospital; Inaugural sign; acute myocardial infarction
• ISSN: 1444-0903; 1445-5994
• DOI: 10.1111/j.1445-5994.2005.00957.x

Background: Studies from overseas indicate that patients with acute myocardial infarction (AMI) symptoms often fail to use the emergency services as recommended, thereby depriving themselves from life‐saving treatment in case of cardiac arrest and delaying the time to myocardial reperfusion in the presence of a coronary occlusion. Aims: To compare patients brought in by ambulance to those not brought in by ambulance and to question why some patients do not use the emergency services when presenting to hospital with AMI symptoms. Methods: Prospective interview and follow up of consecutive patients presenting with AMI symptoms to the emergency department of a tertiary hospital in a metropolitan area within a 1‐month period. Results: Of the 215 patients presenting to the emergency department, 113 (53%) arrived by private transportation. Sixty (53%) of these felt their symptoms did not warrant calling the ambulance, 17 (15%) had first consulted their general practitioner. The private transport group accounted for 28% of documented AMI. Conclusions: A large proportion of patients with AMI symptoms refrain from calling the emergency services because they do not consider themselves critically ill. Education programmes appear to be warranted because more appropriate use of emergency services will save lives. (Intern Med J 2005; 35: 668–671)