Related Experiment Video
Updated: Jun 14, 2025
04:24
A Novel Digital Platform for a Monitored Home-based Cardiac Rehabilitation Program
Published on: April 19, 2019
11.5K
Initial Care Pathway in Acute Heart Failure From Home to Hospital
Pia Harjola1, Veli-Pekka Harjola1, Òscar Miró2
1Emergency Medicine, University of Helsinki and Department of Emergency Medicine and Services, Helsinki University Hospital, Helsinki, Finland.
Clinical Cardiology
|June 11, 2025
Summary
Emergency medical services (EMS) use in acute heart failure (AHF) varies globally. Patients arriving via EMS often receive limited pre-hospital care and experience worse outcomes compared to those self-presenting.
Area of Science:
- Cardiology
- Emergency Medicine
- Public Health
Background:
- Acute heart failure (AHF) presents a significant challenge with a generally poor prognosis.
- The impact of early management strategies, particularly the time-sensitivity of interventions for AHF, remains a subject of ongoing research with conflicting findings.
- Understanding the role and outcomes of patients with AHF who utilize emergency medical services (EMS) is crucial for improving patient care.
Purpose of the Study:
- To systematically review current literature on acute heart failure patients managed by emergency medical services (EMS).
- To analyze the early pre-hospital management strategies employed by EMS for AHF patients.
- To compare patient outcomes between AHF patients arriving via EMS and those self-presenting to the emergency department.
Main Methods:
- A comprehensive literature search was conducted in PubMed and Scopus databases.
- Studies published from database inception until November 2022 were included.
- The review focused on comparing acute heart failure patients arriving via EMS versus non-EMS (self-presenting) to the emergency department.
Main Results:
- Five studies met the inclusion criteria, revealing significant international variation in the percentage of acute heart failure patients using EMS (ranging from 11.5% to 61.8%).
- Pre-hospital management varied, with the use of non-invasive ventilation (NIV) being rare (0-4%), while vasodilators and diuretics were more common but inconsistently applied.
- Three studies reported significantly higher 30-day mortality rates for EMS-transported AHF patients compared to non-EMS patients, with mortality differences ranging from 5.6% vs. 3.5% to 15.0% vs. 6.9%.
Conclusions:
- There is considerable international variability in the utilization of EMS and the nature of pre-hospital management for acute heart failure.
- Current pre-hospital management of AHF by EMS appears generally limited in scope and application.
- Patients with acute heart failure who arrive at the hospital via EMS tend to experience poorer health outcomes compared to those who self-present.
More Related Videos
Related Concept Videos
01:21Planning Nursing Care I
4.4K
The planning phase of the nursing process helps nurses set priorities, outline patient-centered goals and expected outcomes, and tailor nursing interventions to align with the aligned care plan. Through the planning phase, the nurse applies critical thinking skills to align and develop interventions according to the patient's needs. It provides continuity of care allowing patients to receive the maximum benefit from treatment. It serves as a pilot plan for allocating individual staff to a...
4.4K
01:17Pathophysiology of Heart Failure
1.5K
Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...
1.5K
01:29Documentation in Long-Term and Home Healthcare Setting
875
Documentation in long-term care facilities and home healthcare settings is crucial for ensuring continuous, coordinated, and comprehensive care for patients. Each setting has its specific documentation processes and tools:
Long-Term Care Facilities
Long-Term Care Facilities
875
01:29Acute Respiratory Failure-V
124
The treatment for acute respiratory failure varies based on factors like the underlying cause, overall health, and severity. A collaborative healthcare team is essential for early detection, often through arterial blood gas analysis. Identifying the cause is the primary goal, with treatment strategies adjusted for ventilation/perfusion (V/Q) mismatch, shunting, or diffusion impairment.
Ensure that patients are monitored continuously for their response to therapy, including changes in...
Ensure that patients are monitored continuously for their response to therapy, including changes in...
124
01:19Restorative Care
1.9K
Restorative care is provided once a patient has been discharged from a healthcare facility and requires additional services. The additional services include home care, rehabilitation programs, and extended care. Restorative care centers help the patient regain their previous level of functioning or acquire a new level of functioning due to the incapacitating effects of a disease or a disability. It aims to assist patients in enhancing their quality of life by encouraging independence,...
1.9K
01:31Discharge Summary Forms
749
The discharge summary is crucial as it enables a smooth transition from a healthcare facility to a patient's home or another care setting. This critical document facilitates seamless continuity of care, ensuring patients receive the necessary support and attention.
Here's a detailed look at the key components and guidelines for preparing a discharge summary:
Here's a detailed look at the key components and guidelines for preparing a discharge summary:
749