RESUMO
Background: data on the use of emergency medical services [EMS] by patients with cardiac conditions in the Gulf region are scarce, and prior studies have suggested underutilization. Patient perception and knowledge of EMS care is critical to proper utilization of such services
Objectives: to estimate utilization, knowledge, and perceptions of EMS among patients with ST-elevation myocardial infarction [STEMI] in the Emirate of Abu Dhabi
Methods: we conducted a multicenter prospective study of consecutive patients admitted with STEMI in four government?operated hospitals in Abu Dhabi. Semi?structured interviews were conducted with patients to assess the rationale for choosing their prehospital mode of transport and their knowledge of EMS services
Results: of 587 patients with STEMI [age 51 +/- 11 years, male 95%], only 15% presented through EMS, and the remainder came via private transport. Over half of the participants [55%] stated that they did not know the telephone number for EMS. The most common reasons stated for not using EMS were that private transport was quicker [40%] or easier [11%]. A small percentage of participants [7%] did not use EMS because they did not think their symptoms were cardiac?related or warranted an EMS call. Stated reasons for not using EMS did not significantly differ by age, gender, or primary language of the patients
Conclusions: EMS care for STEMI is grossly underutilized in Abu Dhabi. Patient knowledge and perceptions may contribute to underutilization, and public education efforts are needed to raise their perception and knowledge of EMS
RESUMO
Introduction: Physician perceptions about emergency medical services [EMS] are important determinants of improving pre-hospital care for cardiac emergencies. No data exist on physician attitudes towards EMS care of patients with ST-Elevation Myocardial Infarction [STEMI] in the Emirate of Abu Dhabi
Objectives: To describe the perceptions towards EMS among physicians caring for patients with STEMI in Abu Dhabi
Methods: We surveyed a convenience sample of physicians involved in the care of patients with STEMI [emergency medicine, cardiology, cardiothoracic surgery and intensive care] in four government facilities with 24/7 Primary PCI in the Emirate of Abu Dhabi. Surveys were distributed using dedicated email links, and used 5-point Likert scales to assess perceptions and attitudes to EMS
Results: Of 106 physician respondents, most were male [82%], practicing in emergency medicine [47%] or cardiology [44%] and the majority [63%] had been in practice for >10 years. Less than half of the responders [42%] were "Somewhat Satisfied" [35%] or "Very Satisfied" [7%] with current EMS level of care for STEMI patients. Most respondents were "Very Likely" [67%] to advise a patient with a cardiac emergency to use EMS, but only 39% felt the same for themselves or their family. Most responders were supportive [i.e. "Strongly Agree"] of the following steps to improve EMS care: 12-lead ECG and telemetry to ED by EMS [69%], EMS triage of STEMI to PCI facilities [65%], and activation of PCI teams by EMS [58%]. Only 19% were supportive of pre-hospital fibrinolytics by EMS. There were no significant differences in the responses among the specialties
Conclusions: Most physicians involved in STEMI care in Abu Dhabi are very likely to advise patients to use EMS for a cardiac emergency, but less likely to do so for themselves or their families. Different specialties had concordant opinions regarding steps to improve pre-hospital EMS care for STEMI