202 paper - Delay in Calling 9-1-1 for Complaints of Chest...

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Delay in Calling 9-1-1 for Complaints of Chest Pains 1 CLEMSON UNIVERSITY Delay in Calling 9-1-1 for Complaints of Chest Pain Heather Parnham HLTH 202 Section 1 December 5, 2008
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Delay in Calling 9-1-1 for Complaints of Chest Pains 3 Introduction Heart disease is the leading cause of mortality in the United States, accounting for more than four hundred thousand deaths each year (Dulberg). Each year, about 1,250,000 people experience an acute MI, or heart attack (Brown). These statistics show that a little less than half of the people that have a heart attack each year die. Typical symptoms of a MI are chest pain/discomfort, pain or heaviness in the left arm, shortness of breath, and a sense of dread (Dracup). However, chest pain may have radiated to the arm, neck jaw. In addition, not all cases have the same symptoms; women present more atypical symptoms than men such as nausea, dyspnea, and sweating (Kerr). It has been reported that 48% of patients with symptoms of a MI die before accessing health services (Kerr). Administration of thrombolytic drugs within one hour of symptoms onset results in little or no evidence of myocardial damage in many patients (Dracup). Thrombolytic therapy can reduce mortality of 25%, if initiated within one hour of onset of symptoms (Brown). Unfortunately, only a fraction of people make it to the hospital in time (Brown). Patient delay, time between onset of symptoms and the patient’s decision to seek care, represents the most important factor in delay to treatment (Kerr). The median delay in seeking care after the onset of MI symptoms range from 2 – 6.4 hours (Dracup). The time it takes to administer thrombolytic therapy treatment for appropriate cases is the key factor in determining survival and quality of life (Kerr). Quick use of EMS for MI symptoms can dramatically shorten overall prehospital delay time (Dulberg). Advocates of the EMS consider patient care to start when EMS personnel reach the scene of an MI (Hutchings). EMS is a critical part of prehospital care for MI patients providing early diagnosis/treatment, forewarning of patient arrival to the hospital, ability to address any life threatening complications during transport (Brown). However, only about 50% of people call for an ambulance (Brown). Most deaths from CHD take place outside of the hospital, assumedly from arrhythmia, which can be detected and treated by ambulance paramedics (Kerr). It may be expected that patients who transport themselves would arrive at the hospital more quickly because the
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Delay in Calling 9-1-1 for Complaints of Chest Pains 4 journey is one way (Becker). However, studies have found that transport for patients was longer in an ambulance but they received care faster. Calling 911 will usually result in quicker access to care compared with private transport to an ED (Hutchings). Phone surveys asked people if they would call 911 if they had a cardiac arrest and 89.4% of those
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This note was uploaded on 11/11/2009 for the course HLTH 202 taught by Professor Welsh during the Fall '08 term at Clemson.

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202 paper - Delay in Calling 9-1-1 for Complaints of Chest...

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