The objectives of this study were to assess the impact of the new 'Shahal' (pre-hospital cardiac service) on subscribers' 'decision time'. A professional 24-h mobile emergency cardiac service has been set up, monitored by intensive care nurses via a central computerized operation unit. All subscribers carry a cardiobeeper for trans-telephonic transmission of a 3-lead electrocardiogram as well as an automatic intramuscular lidocaine injector for self-injection. During a 1-year period, data from 10,304 subscribers' charts were reviewed and analysed. Seventy-nine percent were cardiac patients and 15% were completely healthy. Median decision time for the general population was 44 min (range 3 h); 59% of subscribers called within 1 h from onset of symptoms and 29% delayed calling for 3 h and more. The healthy subjects alerted the service significantly earlier (29 min). Three patterns of behaviour emerged from analysis of the daily distribution of calls.
Roth et al. (Sun,) studied this question.