Key result
Non-pain heart descriptors lead acute MI emergency calls at ~23%, slightly edging out chest pain.
Why the study?
Pre-hospital identification of AMI by dispatchers is challenging in diverse South African populations, prompting an evaluation of terms callers use when requesting an ambulance for AMI.
Observational (n=50)
No
Answers are grounded in this paper and cite their sources.
South African callers predominantly use non-pain heart-related descriptors ('heart attack') and chest pain descriptors when calling an ambulance for AMI, though 28% of calls lacked any pain, heart, or chest descriptors, highlighting the need for structured dispatch triage algorithms.
INTRODUCTION: Acute myocardial infarction (AMI) is a time sensitive emergency. In resource limited settings, prompt identification and management of patients experiencing AMI in the pre-hospital setting may minimise the negative consequences associated with overburdened emergency medical and hospital services. Expedited care thus, in part, relies on the dispatch of appropriate pre-hospital medical providers by emergency medical dispatchers. Identification of these patients in call centres is challenging due to a highly diverse South African society, with multiple languages, cultures, and levels of education. The aim of this study was therefore, to describe the terms used by members of the South African public when calling for an ambulance for patients suffering an AMI. METHODS: In this qualitative study, we performed content analysis to identify keywords and phrases that callers used to describe patients who were experiencing an advanced life support (ALS) paramedic-diagnosed AMI. Using the unique case reference number of randomly selected AMI cases, original voice recordings between the caller and emergency medical dispatcher at the time of the emergency were extracted and transcribed verbatim. Descriptors of AMI were identified, coded and categorised using content analysis, and quantified. RESULTS: (n = 16; 23.2%), followed by the code describing pain in the chest (n = 15; 21.7%). CONCLUSION: South African callers use a consistent set of descriptors when requesting an ambulance for a patient experiencing an AMI. The most common of these are non-pain descriptors related to the heart. These descriptors may ultimately be used in developing validated algorithms to assist dispatch decisions. In this way, we hope to expedite the correct level of care to these time- critical patients and prevent the unnecessary dispatch of limitedly available ALS paramedics to inappropriate cases.
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Buma et al. (2020) conducted an observational in Acute myocardial infarction (AMI) (n=50). Unprompted caller descriptors of acute myocardial infarction during emergency ambulance dispatch calls was evaluated on Frequency of coded meaning units and descriptors of acute myocardial infarction used by callers. South African emergency callers describing acute myocardial infarction most frequently used non-pain heart-related descriptors (23.2% of meaning units) and chest pain descriptors (21.7%).
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