9-1-1 Caller-Described Heart Attack Symptoms.
Greg Scott1, Christopher Olola1, Matthew Miko1
1International Academies of Emergency Dispatch, Salt Lake City, Utah, USA.
Prehospital and Disaster Medicine
|July 18, 2022
Summary
Emergency Medical Dispatchers often use the chest pain/discomfort protocol for heart attacks (HAs). However, callers frequently describe HA symptoms beyond chest pain, highlighting the need for dispatcher training in symptom clarification.
Area of Science:
- Emergency Medical Services
- Cardiology
- Public Health
Background:
- Heart attacks (HAs) can present with diverse symptoms, not always classic chest pain (CP) or chest discomfort (CD).
- Emergency Medical Dispatchers (EMDs) utilize the CP/CD protocol for various HA presentations, but the frequency of non-CP/CD symptom reporting is unclear.
Purpose of the Study:
- To analyze caller descriptions of primary and secondary heart attack (HA) symptoms.
- To evaluate the utilization of a case entry (CE) question clarifier by Emergency Medical Dispatchers (EMDs).
Main Methods:
- Retrospective analysis of 1,261 randomly selected Emergency Medical Dispatcher (EMD) audio recordings from US emergency communication centers.
- Quality Performance Review (QPR) experts documented initial caller problem descriptions, CE clarifier use, and EMD-assigned determinant codes.
Main Results:
- The case entry (CE) clarifier was used in only 8.5% of reviewed heart attack (HA) calls.
- Chest pain/discomfort (CP/CD) symptoms were reported in 87.0% of cases, either alone or with other issues.
- CP alone was the most frequent symptom (70.8%), with HA alone (4.0%) and CD alone (1.4%) being less common.
Conclusions:
- Callers describe potential heart attacks (HAs) using varied terminology, with chest pain (CP) being most common.
- Less frequent HA symptoms may be underreported or missed.
- EMDs require enhanced training to effectively use clarifying questions for initial "heart attack" complaints to elicit comprehensive symptom information.
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