Emergency Care

EMS transport is underused by patients with a certain type of heart attack

The quicker that patients with a particular kind of heart attack known as ST-segment-elevation myocardial infarction (STEMI) get to the hospital and receive balloon angioplasty to open up blocked arteries, the more likely they are to have better outcomes. Patients transported to the hospital by emergency medical services (EMS) had significantly shorter delays than self-transported individuals between symptom onset and hospital arrival (median 89 versus 120 minutes) and door-to-balloon time (63 versus 76 minutes), found a new study.

Researchers compared patients transported by EMS to those who self-transported to the emergency department among 37,634 STEMI patients. Only 60 percent of the patients used EMS to get to the hospital. Patients who used EMS were more likely to be older and female. They were also more likely to have other medical conditions, to be sicker on presentation, and to live farther from the hospital. Patients who did not use EMS were likely to be younger, male, Hispanic, and live closer to the hospital.

Patients who self-transported had significantly longer delays to hospital arrival after symptom onset and experienced significant delays to STEMI care and reperfusion with angioplasty. The researchers conclude that EMS transport to the hospital remains underused among STEMI patients and that policy interventions to increase EMS use have the potential to decrease total time of reduced blood flow and save heart muscle. This study was supported in part by the Agency for Healthcare Research and Quality (HS16964).

See "Use of emergency medical service transport among patients with ST-segment-elevation myocardial infarction," by Robin Mathews, M.D., Eric D. Peterson, M.D., Shuang Li, M.S., and others in Circulation, 124, pp. 154-163, 2011.

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