9-1-1 Caller-Described Heart Attack Symptoms

Faceless heroes: A content analysis of determinants for the recruitment, career development & retention of Emergency Medical Dispatchers in the United States of America

Clinical Policy: Critical Issues in the Evaluation and Management of Adult Patients With Asymptomatic Hypertension in the Emergency Department

Performing stable angina pectoris: An ethnographic study

Heart disease is the leading cause of death for men and women in the United States, and heart attacks are a major category of heart disease; someone in the United States has a heart attack every 40 seconds (1). February is American Heart Month, an ideal time to remind all adults to focus on their hearts and encourage them, their families, friends, and communities to learn the important signs and symptoms of heart attack and how to respond. Recognizing that someone might be having a heart attack and calling emergency services (9-1-1) are crucial for optimizing access to lifesaving emergency cardiac care and receipt of advanced treatments and improving survival. Five common symptoms of a heart attack are 1) pain or discomfort in the jaw, neck, or back; 2) feeling weak, lightheaded, or faint; 3) chest pain or discomfort; 4) pain or discomfort in the arms or shoulder; and 5) shortness of breath. If someone is suspected to be having a heart attack, 9-1-1 should be called immediately.

Background and objectives: Worldwide, mortality due to cardiovascular diseases (CVD) is a concern of great magnitude. The mortality rate in Bahrain, due to CVD, was 19.5%, 32%, and 21.5% in the years 2005, 2011, and 2013, respectively. The objective was to assess the awareness of Bahraini adults of the early warning symptoms of heart attack (HA) and the need to activate rapid emergency care by calling 999 once recognized. Methods: An observational cross-sectional study included 400 Bahraini adult patients attending primary healthcare centers in Bahrain. Respondents were asked to identify the five warning symptoms of a HA and the first action to be performed while witnessing a HA. HA knowledge score was calculated for each respondent. The study was approved by Bahrain Public Health Research Committee. Results: Based on the evaluation of the knowledge scores of HA symptoms, 71.9% and 28.1% of the participants scored poor and good level of knowledge. In the study, the most recognized symptom of HA was chest pain (70.9%) followed by shortness of breath (60%). In response to the first action to be performed while witnessing a HA, only 59.5% reported that they would contact the emergency services. Conclusion: The level of public awareness about HA symptoms in Bahrain is poor. Community campaigns are required to increase public health knowledge.

Prehospital Transport Time Intervals for Acute Stroke Patients

A 32‐year‐old woman with arthralgias and severe hypotension

Emergency Medical Dispatchers make decisions based on limited information. We aimed to investigate if adding demographic and hospitalization history information to the dispatch process improved precision. This 30-day follow-up study evaluated time-critical emergencies in contact with the emergency phone number 112 in Denmark during 18 months. 'Time-critical' was defined as suspected First Hour Quintet (FHQ) (cardiac arrest, chest pain, stroke, difficulty breathing, trauma). The association of age, sex, and hospitalization history with adverse outcomes was examined using logistic regression. The predictive ability was assessed via area under the curve (AUC) and Hosmer-Lemeshow tests. Of 59,943 patients (median age 63 years, 45% female), 44-45.5% had at least one chronic condition, 3880 (6.47%) died the day or the day after (primary outcome) calling 112. Age 30-59 was associated with increased adjusted odds ratio (OR) of death on day 1 of 3.59 [2.88-4.47]. Male sex was associated with an increased adjusted OR of death on day 1 of 1.37 [1.28-1.47]. Previous hospitalization with nutritional deficiencies (adjusted OR 2.07 [1.47-2.92]) and severe chronic liver disease (adjusted OR 2.02 [1.57-2.59]) was associated with a higher risk of death. For trauma patients, the discriminative ability of the model showed an AUC of 0.74 for death on day 1. Increasing age, male sex, and hospitalization history was associated with increased risk of death on day 1 for FHQ 112 callers. Additional efforts are warranted to clarify the role for risk prediction tools in emergency medical dispatch.

Creating an ideal system of care to address the care forpatients with ST-elevation myocardial infarction (STEMI) iscomplex from both the system’s and patient/family’s perspec-tives. In general, this care is unlike most other hospital care.It typically involves very fast and complex decision makingand, often, sudden transportation to another facility forpercutaneous coronary intervention (PCI). All of this occurswith a potentially critically ill patient and at a time when thefamily is often not immediately available. In this report, weaddress key perspectives from the patient and public point ofview of the current system of care for STEMI patients andhighlight the barriers and gaps that must be addressed by anideal system of care (Table 1).

According to the World Heart Federation research, cardiovascular disease has the highest mortality rate in the world. Heart attacks can come suddenly without showing symptoms. Some symptoms that may appear are like chest pain and short of breath. The study will try to find the profile of attack symptoms of 1076 cardiovascular patients at XYZ Hospital based on age, gender, job, habit, weight-change, ECG, heart noise, breath noise, systolic, diastolic, pulse and sleeping problem. The method using here is the Classification Tree. The study results that the most influence factor to the heart attack symptom is the breath noise. If the breath noise is not normal, 80.5% will have symptom short of breath, for female, 93.6% will have symptom short of breath and for male 69.9% will have symptom short of breath. If the breath noise is normal, 59.3% will have symptom chest of pain. If breath noise is normal, heart voice regular, pulse is not normal, 47.1% will have symptom short of breath. If breath noise is normal, heart noise regular, pulse is normal, 72.3% will have symptom chest pain. If breath noise is normal, heart voice irregular, 47.9% will have symptom short of breath

AHA Scientific Statement: Guide to anticoagulant therapy: heparin: a statement for healthcare professionals from the American Heart Association.

Heart disease is the primary cause of illness and death in the United States. Because improved detection of heart disease can save lives, blood tests have been used for approximately 50 years to detect substances that are present in the blood that indicate either disease or a future risk of the development of a disease (Table). Blood tests detect substances that normally are not present or measure substances that, when elevated above normal levels, indicate disease. View this table: Available Blood-Based Tests for Heart Disease Patients presenting to the emergency department with chest discomfort will have an initial assessment for a possible heart attack (myocardial infarction). Electrocardiograms (ECGs or EKGs) are used in the evaluation of patients with chest discomfort but can be normal or not diagnostic in patients with a myocardial infarction. Thus, blood will be obtained to check for any heart damage that can be indicated by abnormal protein levels in the blood. The specific proteins that are the subjects of these blood tests include: These proteins are normally present within the heart cells and are released into the blood after a heart attack. Their presence in the blood can indicate heart damage. However, some of these proteins (CK, CKMB, and myoglobin) are also found in other muscles. Thus, these proteins are not specific to the heart, and elevated levels within …

Diabetes mellitus, although a chronic disease, also can cause acute, sudden symptoms requiring emergency intervention. In these cases, Emergency Medical Dispatchers (EMDs) must identify true diabetic complaints in order to determine the correct care. In 911 systems utilizing the Medical Priority Dispatch System (MPDS), International Academies of Emergency Dispatch-certified EMDs determine a patient's chief complaint by matching the caller's response to an initial pre-scripted question to one of 37 possible chief complaints protocols. The ability of EMDs to identify true diabetic-triggered events reported through 911 has not been studied. The primary objective of this study was to determine the percentage of EMD-recorded patient cases (using the Diabetic Problems protocol in the MPDS) that were confirmed by either attending paramedics or the hospital as experiencing a diabetic-triggered event. This was a retrospective study involving six hospitals, one fire department, and one ambulance service in Salt Lake City, Utah USA. Dispatch data for one year recorded under the Diabetic Problems protocol, along with the associated paramedic and hospital outcome data, were reviewed/analyzed. The outcome measures were: the percentage of cases that had diabetic history, percentage of EMD-identified diabetic problems cases that were confirmed by Emergency Medical Services (EMS) and/or hospital records as true diabetic-triggered events, and percentage of EMD-identified diabetic patients who also had other medical conditions. A diabetic-triggered event was defined as one in which the patient's emergency was directly caused by diabetes or its medical management. Descriptive statistics were used for categorical measures and parametric statistical methods assessed the differences between study groups, for continuous measures. Three-hundred ninety-three patient cases were assigned to the Diabetic Problems Chief Complaint protocol. Of the 367 (93.4%) patients who had a documented history of diabetes, 279 (76%) were determined to have had a diabetic-triggered event. However, only 12 (3.6%) initially assigned to this protocol did not have a confirmed history of diabetes. Using the MPDS to select the Diabetic Problems Chief Complaint protocol, the EMDs correctly identified a true diabetic-triggered event the majority of the time. However, many patients had other medical conditions, which complicated the initial classification of true diabetic-triggered events. Future studies should examine the associations between the five specific Diabetic Problems Chief Complaint protocol determinant codes (triage priority levels) and severity measures, eg, blood sugar level and Glasgow Coma Score.

Cardiology Patient Page. C-reactive protein: a simple test to help predict risk of heart attack and stroke.

In out-of-hospital cardiac arrest patients, does the description of any specific symptoms to the emergency medical dispatcher improve the accuracy of the diagnosis of cardiac arrest: A systematic review of the literature