Study: Calling 911 for heart attacks in rural areas leads to faster care

Research showed 52 percent of STEMI patients in rural areas arrived to the ER in personal vehicles

BALTIMORE — An American Heart Association (AHA) study shows that heart attack patients in rural areas who call 911 receive care faster than heart attack patients who get to the hospital without the help of emergency responders.

Researchers reviewed data on 774 patients who lived in rural Minnesota, North Dakota and South Dakota, who were treated between 2013 and 2014 for a STEMI. Just over half of the STEMI patients—52 percent—arrived in their own vehicles instead of calling 911.

“The biggest implication is raising awareness so the public understands the vital role of EMS in health care,” said lead study author John M. Gallagher, MD, EMS Medical Director, Winona Area Ambulance Service in Winona, Minnesota. “EMS continues to be viewed as only a ‘ride’ but utilizing EMS as part of the healthcare system not only allows for treatment from the time they arrive at your door, but also has been proven to shorten time to reperfusion treatment faster."

The data included STEMI patients from 19 hospitals participating in Mission Lifeline, an AHA initiative to improve STEMI systems of care. All patients in the study received percutaneous coronary intervention (PCI) treatment to restore blood flow.

When comparing arrival times, researchers found:

  • Patients brought to the hospital by ambulance took an average of about 26 minutes to get there compared with an average of 38 minutes for patients who drove themselves.
  • The average time from hospital arrival to undergoing artery-opening procedures in the cardiac catheterization lab was an average of 42 minutes for those who traveled by ambulance versus 57 minutes for those who drove themselves.

The study did not investigate why patients chose not to call 911 and instead find their own transportation to the hospital. Gallagher said the public needs to learn to trust EMS providers, who are skilled in responding to a heart attack and can activate care much more quickly than patients seeking care on their own.

“The public needs to start seeing EMS as the first access point to health care,” he said. “EMS providers have a plan in place for inclement weather and travel conditions. Their unique capabilities to deliver lifesaving care en-route to the hospital should not be underestimated. The benefits of 20 minutes saved in their heart attack timeline are huge.”

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