Hostname: page-component-848d4c4894-5nwft Total loading time: 0 Render date: 2024-05-09T13:41:12.460Z Has data issue: false hasContentIssue false
  • English
  • Français

9-1-1 Caller-Described Heart Attack Symptoms

Published online by Cambridge University Press:  18 July 2022

Greg Scott ,
Christopher Olola Open the ORCID record for Christopher Olola [Opens in a new window] ,
Matthew Miko ,
Brett Patterson ,
Joleen Quigg ,
Chris Davis ,
Richard Lindfors ,
Jayme Tidwell ,
Kevin Pagenkop  and
John Lofgren
...Show all authors
Greg Scott
Affiliation:
International Academies of Emergency Dispatch, Salt Lake City, Utah, USA
Christopher Olola*
Affiliation:
International Academies of Emergency Dispatch, Salt Lake City, Utah, USA
Matthew Miko
Affiliation:
International Academies of Emergency Dispatch, Salt Lake City, Utah, USA
Brett Patterson
Affiliation:
International Academies of Emergency Dispatch, Salt Lake City, Utah, USA
Joleen Quigg
Affiliation:
MedStar Mobile Healthcare, Fort Worth, Texas, USA
Chris Davis
Affiliation:
Butler County Emergency Communications, El Dorado, Kansas, USA
Richard Lindfors
Affiliation:
Richmond Ambulance Authority, Richmond, Virginia, USA
Jayme Tidwell
Affiliation:
Priority Dispatch Corp., Inc., Salt Lake City, Utah, USA
Kevin Pagenkop
Affiliation:
Independent Contractor (QPR), Priority Dispatch Corp., Reno, Nevada, USA
John Lofgren
Affiliation:
Independent Contractor (QPR), Priority Dispatch Corp., Colorado Springs, Colorado, USA
Jaci Fox
Affiliation:
Independent Contractor (QPR), Priority Dispatch Corp., Medicine Hat, AB, Canada
Jeff Clawson
Affiliation:
International Academies of Emergency Dispatch, Salt Lake City, Utah, USA
*
Correspondence: Christopher Olola, PhD International Academies of Emergency Dispatch 110 S. Regent Street Salt Lake City, Utah84111, USA Email. chris.olola@emergencydispatch.org
Get access Rights & Permissions [Opens in a new window]

Abstract

Introduction:

Heart attacks (HAs) present clinically with varying symptoms, which are not always described by patients as chest pain (CP) or chest discomfort (CD). Emergency Medical Dispatchers (EMDs) select the CP/CD dispatch protocol for non-chest pain HA symptoms or classic HA complaint of CP/CD. Nevertheless, it is still unknown how often callers report HA symptoms other than CP/CD.

Objectives:

The objective of this study was to characterize the caller’s descriptions of the primary HA symptoms, descriptions of the other HA symptoms, and the use of a case entry (CE) question clarifier.

Methods:

A retrospective descriptive study analyzed randomly selected EMD audios (where CD/CD protocol was used) from five accredited emergency communication centers in the United States. Several Quality Performance Review (QPR) experts reviewed the audios and recorded callers’ initial problem descriptions, the use of and responses to the CE question clarifier, including the EMD-assigned final determinant code.

Results:

A total of 1,261 audios were reviewed. The clarifier was used only 8.5% of the time. The CP/CD symptoms were mentioned alone or with other problems 87.0% of the time. Overall, CP symptom was mentioned alone 70.8%, HA alone 4.0%, and CD symptom alone 1.4% of the time.

Conclusion:

9-1-1 callers report potential HA cases using a variety of terms and descriptions—most commonly CP. Other less-common symptoms associated with a HA may be mentioned. Therefore, EMDs must be well-trained to be prepared to probe the caller with a clarifying query to elicit more specific information when “having a heart attack” is the only complaint initially mentioned.

Keywords

cardiovascular diseaseschest discomfortchest painheart attack symptomsmyocardial infarction
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 37 , Issue 5 , October 2022 , pp. 609 - 615
Check for updates
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of the World Association for Disaster and Emergency Medicine

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Horne, R, James, D, Petrie, K, Weinman, J, Vincent, R. Patients’ interpretation of symptoms as a cause of delay in reaching hospital during acute myocardial infarction. Heart. 2000;83(4):388–393.CrossRefGoogle ScholarPubMed
Cohn, PF. Silent myocardial ischemia: recent developments. Curr Atheroscler Rep. 2005;7(2):155–163.CrossRefGoogle ScholarPubMed
Hochman, J, Tamis, J, Thompson, T, et al. Sex, clinical presentation, and outcome in patients with acute coronary syndromes. N Engl J Med. 1999;341(4):226–232.CrossRefGoogle ScholarPubMed
Milner, KA, Vaccarino, V, Arnold, AL, Funk, M, Goldberg, RJ. Gender and age differences in chief complaints of acute myocardial infarction (Worcester heart attack study). Am J Cardiol. 2004;93(5):606–608.CrossRefGoogle Scholar
Dracup, K, Moser, DK, Eisenberg, M, Meischke, H, Alonzo, AA, Braslow, A. Causes of delay in seeking treatment for heart attack symptoms. Soc Sci Med. 1995;40(3):379–392.CrossRefGoogle ScholarPubMed
National Institutes of Health. Emergency Medical Dispatching: Rapid Identification and Treatment of Acute Myocardial Infarction. Bethesda, Maryland USA: NIH Publications; 1994; No. 94.Google Scholar
Finn, JC, Bett, JHN, Shilton, TR, Cunningham, C, Thompson, PL. Patient delay in responding to symptoms of possible heart attack: can we reduce time to care? Med J Aust. 2007;187(5):293–298.CrossRefGoogle ScholarPubMed
Patel, A, Fang, J, Gillespie, C, Odom, E, Luncheon, C, Ayala, C. Awareness of heart attack signs and symptoms and calling 9-1-1 among US adults. J Am Coll Cardiol. 2018;71(7):808–809.CrossRefGoogle Scholar
Fang, J, Keenan, N, Dai, S. Disparities in adult awareness of heart attack warning signs and symptoms—14 states, 2005. MMWR Morb Mortal Wkly Rep. 2008;57(7):175–178.Google Scholar
Ornato, J, Hand, M. Warning signs of a heart attack. Circulation. 2001;104(11):1212–1213.CrossRefGoogle ScholarPubMed
Goff, D, Mitchel, P, Finnegan, J, et al. Knowledge of heart attack symptoms in 20 US communities. Results from the rapid early action for coronary treatment community trial. Prev Med. 2004;38(1):85–93.CrossRefGoogle ScholarPubMed
Mol, KA, Rahel, BM, Meeder, JG, van Casteren, Doevendans PA, Cramer, MJM. Delays in the treatment of patients with acute coronary syndrome: focus on pre-hospital delays and non-ST-elevated myocardial infarction. Int J Cardiol. 2016;221:1061–1066.CrossRefGoogle ScholarPubMed
Barron, T, Clawson, J, Scott, G, et al. Aspirin administration by emergency medical dispatchers using a protocol-driven aspirin diagnostic and instruction tool. Emerg Med J. 2013;30(7):572–578.CrossRefGoogle ScholarPubMed
Scott, G, Clawson, J, Gardett, I, et al. 9-1-1 triage of non-traumatic chest pain: association with hospital diagnosis. Prehosp Emerg Care. 2017;21(4):525–534.CrossRefGoogle ScholarPubMed
Olola, C, Broadbent, M, Gardett, I, Scott, G, Clawson, J. Characteristics of acute myocardial infarction cases coded as low acuity at dispatch. Ann Emerg Dispatch Resp. 2017;5(2):8–14.Google Scholar