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- Henriksson, Catrin, et al.
(författare)
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Knowledge and attitudes toward seeking medical care for AMI-symptoms
- 2011
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Ingår i: International Journal of Cardiology. - : Elsevier BV. - 0167-5273 .- 1874-1754. ; 147:2, s. 224-227
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Tidskriftsartikel (refereegranskat)abstract
- Background: Time is crucial when an acute myocardial infarction (AMI) occurs, but patients often wait before seeking medical care. Aim: To investigate and compare patients' and relatives' knowledge of AMI, attitudes toward seeking medical care, and intended behaviour if AMI-symptoms occur. Methods: The present study was a descriptive, multicentre study. Participants were AMI-patients <= 75 years (n = 364) and relatives to AMI-patients (n = 319). Questionnaires were used to explore the participants' knowledge of AMI and attitudes toward seeking medical care. Results: Both patients and relatives appeared to act more appropriate to someone else's chest pain than to their own. Patients did not have better knowledge of AMI-symptoms than relatives. Women would more often contact someone else before seeking medical care. A greater percentage of elderly (65-75 years), compared to younger individuals, reported that they would call for an ambulance if chest pain occurred. Conclusions: There were only minor differences between patients and relatives, regarding both knowledge and attitudes. It seems easier to act correctly as a bystander than as a patient. Therefore, in order to decrease patients' delay time it is important to educate relatives as well as patients on how to respond to symptoms of an AMI.
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| 2. |
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| 3. |
- Svensson, Leif, et al.
(författare)
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Safety and delay time in prehospital thrombolysis of acute myocardial infarction in urban and rural areas in Sweden.
- 2003
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Ingår i: The American journal of emergency medicine. - : Elsevier BV. - 0735-6757 .- 1532-8171. ; 21:4, s. 263-70
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Tidskriftsartikel (refereegranskat)abstract
- Sixteen hospitals in Sweden, including those in urban and more sparsely populated areas, and the associated ambulance organizations were enrolled in a prospective evaluation of the feasibility of treating patients with a ST-elevation infarction with a thrombolytic agent (reteplase) before hospital admission. A physician staffed the ambulances in 1% of cases, a nurse in 67%, and a staff nurse in 32% of cases. In all, 64 patients in urban areas and 90 patients in rural areas were included. The occurrence of complications before hospital admission was low and similar in the 2 groups. The median interval between the onset of symptoms and the start of thrombolysis was 1 hour 44 minutes in urban areas versus 2 hours 14 minutes in rural areas (P = 0.03). The median arrival time (interval between onset of symptoms and arrival of the ambulance) tended to be shorter in urban areas (1 hr 10 min vs 1 hr 33 min; not significant) and the median interval between the arrival of the ambulance and the start of thrombolysis was shorter in urban areas (27 min vs 36 min; P < 0.0001). When comparing urban areas with the least-populated rural areas, differences in various delay times became even more marked. Patients in urban areas had a higher ejection fraction and fewer symptoms of heart failure after 30 days and a lower 1-year mortality.
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| 4. |
- Thuresson, Marie, et al.
(författare)
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Factors that influence the use of ambulance in acute coronary syndrome.
- 2008
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Ingår i: American heart journal. - Amsterdam : Elsevier BV. - 1097-6744 .- 0002-8703. ; 156:1, s. 170-6
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: National guidelines recommend activation of the emergency medical service by patients who have symptoms of acute coronary syndrome (ACS). In spite of this, only 50% to 60% of persons with myocardial infarction initiate care by using the emergency medical service. The aim of this study was to define factors influencing the use of ambulance in ACS. METHODS: The method used in this study was a national survey comprising intensive cardiac care units at 11 hospitals in Sweden; 1,939 patients with diagnosed ACS and symptom onset outside the hospital completed a questionnaire a few days after admission. RESULTS: Half of the patients went to the hospital by ambulance. Factors associated with ambulance use were knowledge of the importance of quickly seeking medical care and calling for an ambulance when having chest pain (odds ratio [OR] 3.61, 95% CI 2.43-5.45), abrupt onset of pain reaching maximum intensity within minutes (OR 2.08, 1.62-2.69), nausea or cold sweat (OR 2.02, 1.54-2.65), vertigo or near syncope (OR 1.63, 1.21-2.20), ST-elevation ACS (OR 1.58, 1.21-2.06), increasing age (per year) (OR 1.03, 1.02-1.04), previous history of heart failure (OR 2.48, 1.47-4.26), and distance to the hospital of >5 km (OR 2.0, 1.55-2.59). Those who did not call for an ambulance thought self-transport would be faster or did not believe they were sick enough. CONCLUSIONS: Symptoms, patient characteristics, ACS characteristics, and perceptions and knowledge were all associated with ambulance use in ACS. The fact that knowledge increases ambulance use and the need for behavioral change pose a challenge for health-care professionals.
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| 5. |
- Thuresson, Marie, et al.
(författare)
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Thoughts, actions, and factors associated with prehospital delay in patients with acute coronary syndrome.
- 2007
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Ingår i: Heart & Lung. - Amsterdam : Elsevier BV. - 0147-9563 .- 1527-3288. ; 36:6, s. 398-409
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Tidskriftsartikel (refereegranskat)abstract
- Objective The objective was to study patients’ interpretations, thoughts, and actions after symptom onset in acute coronary syndrome (ACS) in total and in relation to gender, age, history of coronary artery disease, type of syndrome, and residential area and its influence on prehospital delay. Setting We performed a national survey comprising intensive cardiac care units at 11 hospitals in Sweden. Method A total of 1939 patients with diagnosed ACS and symptom onset outside hospital completed a questionnaire containing standardized questions within 3 days after admission. Results Three-quarters of the patients interpreted their symptoms as cardiac in origin, and the most common reason was that they knew someone who had had an acute myocardial infarction. The majority contacted a family member, whereas only 3% directly called for an ambulance. Interpreting the symptoms as cardiac in origin and severe pain were major reasons for deciding to seek medical care. Approaching someone after symptom onset and the belief that the symptoms were cardiac in origin were factors associated with a shorter prehospital delay, whereas taking medication to relieve pain resulted in the opposite. The reaction pattern was influenced by gender, age, a history of coronary artery disease, and the type of ACS, but to a lesser extent by residential area. Conclusions Interpreting symptoms as cardiac in origin and approaching someone after symptom onset were major reasons for a shorter prehospital delay in ACS.
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| 6. |
- Zedigh, Crister, et al.
(författare)
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Aspects on the intensity and the relief of pain in the prehospital phase of acute coronary syndrome: experiences from a randomized clinical trial.
- 2010
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Ingår i: Coronary artery disease. - : Lippincott, Williams & Wilkins. - 1473-5830 .- 0954-6928. ; 21:2, s. 113-20
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Tidskriftsartikel (refereegranskat)abstract
- The primary aim of this study was to evaluate the pain relief and tolerability of two pain-relieving strategies in the prehospital phase of presumed acute coronary syndrome (ACS), and the secondary aim was to assess the relationship between the intensity and relief of pain and heart rate, blood pressure, and ST deviation. Patients with chest pain judged as caused by ACS were randomized (open) to either metoprolol 5 mg intravenously (i.v.) three times at 2-min intervals (n = 84; metoprolol group) or morphine 5 mg i.v. followed by metoprolol 5 mg three times i.v (n = 80; morphine group). Pain was assessed on a 10-grade scale before randomization and 10, 20, and 30 min thereafter. The mean pain score decreased from 6.5 at randomization to 2.8 30 min later, with no significant difference between groups. The percentages with complete pain relief (pain score < or = 1) after 10, 20, and 30 min were 11, 16, and 21%, respectively, with no difference between groups. Hypotension was less frequent in the metoprolol group compared with the morphine group (0 vs. 6.3%; P=0.03), as was nausea/vomiting (7.2 vs. 24.0%; P=0.004). At randomization intensity of pain was associated with degree of ST elevation (P=0.009). The degree of pain relief over 30 min was associated with decrease in heart rate (P=0.03) and decrease in ST elevation (P=0.01).In conclusion, in the prehospital phase of presumed ACS, neither a pain-relieving strategy including an anti-ischemic agent alone nor an analgesic plus anti-ischemic strategy in combination resulted in complete pain relief. Fewer side effects were found with the former strategy. Other pain-relieving strategies need to be evaluated.
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