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Patterns of access to medical care in acute myocardial infarction
Session:
Posters 5 - Écran 9 - Doença Coronária
Speaker:
Paulo Maia Araújo
Congress:
CPC 2019
Topic:
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
Theme:
13. Acute Coronary Syndromes
Subtheme:
13.7 Acute Coronary Syndromes - Other
Session Type:
Posters
FP Number:
---
Authors:
Paulo Maia Araújo; Alzira Nunes; Sofia Torres; Pedro Diogo; Carlos Resende; Maria Júlia Maciel Barbosa
Abstract
<p><strong>Introduction: </strong>Despite the recommendations, a significant proportion of patients [pts] with acute myocardial infarction [AMI] do not activate the Emergency Medical Systems [EMS] (“INEM” in Portugal), thus placing themselves in situations of greater and unnecessary risk.</p> <p><strong>Purpose: </strong>To determine the type of access to medical care in AMI and to evaluate why some patients [pts] do not use the EMS.</p> <p><strong>Methods:</strong> It was conducted a prospective survey study of pts with AMI, admitted between June and December of 2018, which included a questionnaire (performed in the first 24h of admission) and consultation of the clinical records.</p> <p><strong>Results:</strong> 95 pts, of whom 73% were male, with a mean age of 63.8 years (95% CI: 61.2 - 66.5) were initially evaluated. 94.4% of the pts considered that in the presence of symptoms suggestive of AMI, EMS should be activated. However, 47.4% (n=45) did not call the EMS and constituted this study population. The time from the symptoms onset to FMC was longer than 24h in 22.2% and in those who took < 24 hours, the mean delay was 153 minutes (95% CI: 113-192). The FMC was: emergency department of public (51.2%) and private (25.6%) hospitals, family doctor (16.3%) and private physician (7%). These pts sought the FMC alone in 20.9% and accompanied in 79.1% and the transport used was: personal car in 81.4% (driving in 28.6%; conducted by third person in 71.4%), public transport in 11.6%, taxi in 4.7% and walking in 2.3%. Although the majority of these pts (82.2%) had typical chest pain, the main reason for not calling the EMS was thinking the condition wasn’t serious enough (65.9%). Other reasons were: EMS would take longer - 17.1%; symptoms would pass - 9.8%; other - 7.3%.</p> <p><strong>Conclusions: </strong>Unfortunately, there is a significant proportion of pts with AMI that do not use the EMS and directly seek medical care and this was principally due to an underestimation of the severity of the disease. Implementation of educational programs is imperative, to ensure more appropriate use of the EMS.</p>
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