Could ten questions asked by the dispatch center predict the outcome for patients with chest discomfort?

International Journal of Cardiology
Nina RawshaniMartin Gellerstedt

Abstract

From 2009 to 2010, approximately 14,000 consecutive persons who called for the EMS due to chest discomfort were registered. From the seventh month, dispatchers ask 2285 patient ten pre-specified questions. We evaluate which of these questions was independently able to predict an acute coronary syndrome (ACS), life-threatening condition (LTC) and death. The questions asked mainly dealt with previous history and type of symptoms, each with yes/no answers. The dispatcher took a decision on priority; 1) immediately with sirens/blue light; 2) EMS on the scene within 30min; 3) normal waiting time.We examined the relationship between the answers to these questions and subsequent dispatch priority, as well as outcome, in terms of ACS, LTC and all-cause mortality. 2285 patients (mean age 67years, 49% women) took part, of which 12% had a final diagnosis of ACS and 15% had a LTC. There was a significant relationship between all the ten questions and the priority given by dispatchers. Localisation of the discomfort to the center of the chest, more intensive pain, history of angina or myocardial infarction as well as experience of cold sweat were the most important predictors when evaluating the probability of ACS and LTC. Not breathing nor...Continue Reading

References

Jun 24, 2000·JAMA : the Journal of the American Medical Association·J G CantoC I Kiefe
Sep 11, 2002·European Heart Journal·L ErhardtUNKNOWN Task Force on the management of chest pain
Nov 24, 2005·JAMA : the Journal of the American Medical Association·Clifford J Swap, John T Nagurney
Aug 2, 2011·Annals of Emergency Medicine·Meredith EdwardsJudd E Hollander
Apr 4, 2014·Journal of the American Heart Association·Holli A DevonMohamud Daya
Sep 2, 2014·International Journal of Cardiology·Araz RawshaniJohan Herlitz

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Citations

Oct 19, 2019·Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine·Paul-Georges ReuterSandrine Charpentier

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