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Apr 14, 2011

Could Calling 9-1-1 at First Signs of Heart Attack Improve Medical Care?

Ambulances with echocardiograms provide immediate care.

Health providers strongly urge that anyone with symptoms of a heart attack, such as chest pain or shortness of breath, should call 9-1-1 immediately to be taken to a hospital. While only about half of patients with these symptoms choose to follow this advice, research has proven yet again that calling 9-1-1 is the best choice a patient can make to improve outcomes.

For patients with a suspected ST-elevation myocardial infarction (STEMI), a recent study showed that taking an ambulance to the hospital instead of other forms of transportation can have a significant impact on the efficacy of care.  Most patients taking an ambulance have the option to have an electrocardiogram (ECG), a test that records the electrical activity of the heart, while in transit to the hospital. Those receiving an ECG in the ambulance receive significantly faster care for their heart attack, which can make all the difference in immediate and future outcomes.

There are many ways to gauge the swiftness of care – door to activation, door to cath lab, and door to balloon time – all of which help measure the speed at which patients are diagnosed and effectively treated for their conditions. The faster these rates are for patients suffering from STEMI, the higher the likelihood of a positive outcome.  In fact, delayed treatment for STEMI can more than double likelihood of death in patients, both at the hospital and during the following year.

Therefore, findings from this recent study on the use of ECG in ambulances are significant. Patients with STEMI receiving an ECG during the ambulance ride to the hospital had a 62% shorter door to activation time, 44% shorter door to cath lab time, and 26% shorter door-to-balloon time in comparison with those not receiving ECG in transit to the hospital. Of the 360 patients in this study, 44% did not take an ambulance for a heart attack, and of the 56% taking an ambulance, only 57% of those patients received an ECG in transit.

Based on these results, the use of ECG in ambulances should be performed more often on patients presenting symptoms of heart attack. Not only should more ambulances become equipped to perform ECG, certain barriers that prevent the use of ECG in ambulances, such as language barriers and the overlooking atypical heart attack symptoms, also need to be addressed. 

Questions for You to Consider

  • When should I call 9-1-1 if I think I'm having a heart attack?
  • Anyone exhibiting symptoms of a heart attack should call 9-1-1 immediately. Whether symptoms are atypical or go away after time, you should not only go to the hospital but should be sure to call 9-1-1 for an ambulance. Prompt action during and after a heart attack can help save your life.
  • Do all patients with heart attack symptoms receive an ECG during the ambulance ride to the hospital
  • Not all patients receive an ECG during an ambulance ride. If you are exhibiting heart attack symptoms, you should ask the paramedics to perform an ECG on you in the ambulance, if they do not ask you. This is especially important for those with atypical symptoms who are in fact suffering from a heart attack.


Could Calling 9-1-1 at First Signs of Heart Attack Improve Medical Care?

Ambulances with echocardiograms provide immediate care.

Resources to Help You Compare Treatment Options

Guidance from the Agency for Healthcare Research and Quality (AHRQ) in making health decisions

Tom Weiser is CardioSmart

Tom has had two heart attacks triggered by familial hypercholesterolemia (FH). He has become a vocal and educated advocate for his disease and a positive example for his four children.

David Wang is CardioSmart

A heart attack during a work event changed David Wang's life. After working with his cardiologist and cardiac rehab team, David now celebrates "the gift of perspective."

Don's Story: Cardiac Rehab

Don Fick suffered a heart attack while on vacation with his family. After his heart attack, Don made cardiac rehab a priority in his recovery.