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Acute chest pain - A prospective population based study of contacts to Norwegian emergency medical communication centres

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dc.contributor.author Burman, Robert Anders eng
dc.contributor.author Zakariassen, Erik eng
dc.contributor.author Hunskår, Steinar eng
dc.date.accessioned 2012-01-18T14:31:49Z
dc.date.available 2012-01-18T14:31:49Z
dc.date.issued 2011-07-21 eng
dc.identifier.citation BMC Emergency Medicine 2011, 11:9 en
dc.identifier.issn 1471-227X eng
dc.identifier.uri http://hdl.handle.net/1956/5470
dc.description.abstract Background: Acute chest pain is a frequently occurring symptom in patients with medical emergencies and imposes potentially life threatening situations outside hospitals. Little is known about the epidemiology of patients with acute chest pain in a primary care setting in Norway, and we aimed to obtain more representative data on such patients using data from emergency medical communication centres (EMCCs). Methods: Data were collected prospectively during three months in 2007 from three EMCCs, covering 816 000 inhabitants. The EMCCs gathered information on every situation that was triaged as a red response (defined as an “acute” response, with the highest priority), according to the Norwegian Index of Medical Emergencies. Records from ambulances and primary care doctors were subsequently collected. International Classification of Primary Care - 2 symptom codes and The National Committee on Aeronautics (NACA) System scores were assigned retrospectively. Only chest pain patients were included in the study. Results: 5 180 patients were involved in red response situations, of which 21% had chest pain. Estimated rate was 5.4 chest pain cases per 1000 inhabitants per year. NACA-scores indicated that 26% of the patients were in a lifethreatening medical situation. Median prehospital response time was 13 minutes; an ambulance reached the patient in less than 10 minutes in 30% of the cases. Seventy-six per cent of the patients with chest pain were admitted to a hospital for further investigation, 14% received final treatment at a casualty clinic, while 10% had no further investigation by a doctor (“left at the scene”). Conclusions: The majority of patients with acute chest pain were admitted to a hospital for further investigation, but only a quarter of the patients were assessed prehospitally to have a severe illness. This sheds light on the challenges for the EMCCs in deciding the appropriate level of response in patients with acute chest pain. Overtriage is to some extent both expected and desirable to intercept all patients in need of immediate help, but it is also well known that overtriage is resource demanding. Further research is needed to elucidate the challenges in the diagnosis and management of chest pain outside hospitals. en
dc.language.iso eng eng
dc.publisher BioMed Central eng
dc.rights Attribution CC BY eng
dc.rights.uri http://creativecommons.org/licenses/by/2.0/ eng
dc.subject Chest pain eng
dc.subject Emergency medical services eng
dc.title Acute chest pain - A prospective population based study of contacts to Norwegian emergency medical communication centres eng
dc.type Peer reviewed eng
dc.type Journal article eng
dc.subject.nsi VDP::Medical disciplines: 700::Health sciences: 800::Community medicine, Social medicine: 801 eng
dc.subject.nsi VDP::Medical disciplines: 700::Clinical medical disciplines: 750::Cardiology: 771 eng
dc.rights.holder Copyright 2011 Burman et al; licensee BioMed Central Ltd.
dc.type.version publishedVersion eng
bora.peerreviewed Peer reviewed eng
bora.cristinID 882802 eng
bibo.doi http://dx.doi.org/10.1186/1471-227X-11-9 eng
dc.identifier.cristinID 882802 eng
dc.identifier.doi http://dx.doi.org/10.1186/1471-227X-11-9


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