Retrospective analysis of interventions of the Prague Emergency Medical Services in patients with acute coronary syndrome
Abstract
Aim: The primary aim of the study is to compare the time parameters of cases of acute coronary syndromes (ACS), resp. acute myocardial infarction (AMI) and the secondary objective is to evaluate the therapy provided using different teams of emergency medical services (EMS). Methodology: Retrospective analysis of data of medical records for patients with a primary or secondary diagnosis belonging to the group of ACS for the period from 1 January 2018 to 31 December 2019, the observed subgroup is the diagnosis of AMI.
The calls were divided into three groups according to the EMS team: paramedics' team (RZP), RZP team and physician in the rendezvous system (RV) and team with advanced care paramedic (UM). The parameters monitored were: (1) the time spent at the site of call; (2) the time from contact to arrival at the hospital, and (3) the drugs administered acetylsalicylic acid and heparin.
Results: The time parameters were evaluated in a group of 2080 calls to the ACS, of which were 945 calls to the AMI. In ACS in general, the average time of treatment of acute coronary syndrome at the site of call was the shortest in the RZP (23.0 +/- 10.9 minutes) team compared to RV (25.8 +/- 13.1 minutes) and UM (24.5 +/- 8.0 minutes) (ANOVA, p<0.05).
The longest times from contact to reach the hospital were achieved in RV (35.3 +/- 15.4 minutes) compared to RZP (33.1 +/- 12.7 minutes) and UM (32.7 +/- 8.7 minutes) (ANOVA, p<0.05). Conclusion: Generally, RZP teams are an effective tool for the treatment of patients with ACS.
The use of UM team leads to more frequent administration of appropriate medication in comparison with RZP in the case of diagnosis of AMI thus the use of UM team seems to be an effective alternative to RV teams.