Characterization of ST-Elevation Myocardial Infarction Cases: Association Between Specific Dispatcher-Assigned...

Area of Science:

• Emergency Medicine
• Cardiology
• Public Health

Background:

• ST-elevation myocardial infarction (STEMI) is a critical condition requiring rapid diagnosis and treatment.
• Effective dispatch protocols are essential for timely patient care and improved outcomes.
• The Medical Priority Dispatch System (MPDS) is utilized by Emergency Medical Dispatchers (EMDs) to identify critical conditions like STEMI.

Purpose of the Study:

• To determine the association between hospital-confirmed STEMI cases and specific MPDS dispatch determinant codes.
• To identify the treatments administered to STEMI patients transported by ambulance.
• To evaluate the effectiveness of dispatch protocols in identifying STEMI for pre-hospital care.

Main Methods:

• Retrospective analysis of deidentified dispatch and hospital data from Qatar's Ambulance Service (January 2018 - May 2021).
• Comparison of patient demographics with dispatch measures, including chief complaint and determinant codes.
• Inclusion of Percutaneous Coronary Intervention (PCI) treatment data.

Main Results:

• A total of 2,607 STEMI cases were analyzed after exclusions.
• The majority of STEMI patients (86.0%) were classified as high priority, with chest pain as the chief complaint (62.9%).
• Nearly all STEMI patients (99.0%) received PCI treatment, with no significant differences based on demographics or dispatch measures.

Conclusions:

• STEMI patients in Qatar, predominantly male, receive adequate acute care regardless of demographics, despite potential language barriers.
• EMDs should be trained to clarify chief complaints, especially considering language differences, to improve STEMI identification.
• Refinements in MPDS questioning and EMD training may enhance early detection of STEMI, particularly with non-classic symptoms.