Ambulance Service of Victoria, Melbourne, VIC
Monash University, Melbourne, VIC.
Med J Aust. 2017 Jan 16;206(1):30-35. doi: 10.5694/mja16.00341.
To evaluate the impact of comprehensive public awareness campaigns by the National Heart Foundation of Australia on emergency medical service (EMS) use by people with chest pain.
DESIGN, SETTING AND PARTICIPANTS: A retrospective analysis of 253428 emergency ambulance attendances for non-traumatic chest pain in Melbourne, January 2008 - December 2013. Time series analyses, adjusted for underlying trend and seasonal effects, assessed the impact of mass media campaigns on EMS use.
Monthly ambulance attendances.
The median number of monthly ambulance attendances for chest pain was 3609 (IQR, 3011-3891), but was higher in campaign months than in non-campaign months (3880 v 3234, P<0.001). After adjustments, campaign activity was associated with a 10.7% increase (95% CI, 6.5-14.9%; P<0.001) in monthly ambulance use for chest pain, and a 15.4% increase (95% CI, 10.1-20.9%; P<0.001) when the two-month lag periods were included. Clinical presentations for suspected acute coronary syndromes, as determined by paramedics, increased by 11.3% (95% CI, 6.9-15.9%; P<0.001) during campaigns. Although the number of patients transported to hospital by ambulance increased by 10.0% (95% CI, 6.1-14.2%; P<0.001) during campaign months, the number of patients not transported to hospital also increased, by 13.9% (95% CI, 8.3-19.8%; P<0.001).
A public awareness campaign about responding to prodromal acute myocardial infarction symptoms was associated with an increase in EMS use by people with chest pain and suspected acute coronary syndromes. Campaign activity may also lead to increased EMS use in low risk populations.
评估澳大利亚国家心脏基金会开展的综合性公众意识宣传活动对胸痛人群使用紧急医疗服务(EMS)的影响。
设计、地点和参与者:这是一项对 2008 年 1 月至 2013 年 12 月墨尔本 253428 例非创伤性胸痛急诊救护车就诊的回顾性分析。时间序列分析,调整了潜在趋势和季节性影响,评估了大众媒体宣传活动对 EMS 使用的影响。
每月救护车就诊人数。
胸痛每月救护车就诊的中位数为 3609 例(IQR,3011-3891),但在宣传活动月份高于非宣传活动月份(3880 例比 3234 例,P<0.001)。调整后,宣传活动与胸痛每月救护车使用量增加 10.7%(95%CI,6.5-14.9%;P<0.001)相关,包括两个月的滞后期后增加 15.4%(95%CI,10.1-20.9%;P<0.001)。护理人员确定的疑似急性冠状动脉综合征的临床表现在宣传活动期间增加了 11.3%(95%CI,6.9-15.9%;P<0.001)。虽然在宣传活动期间,通过救护车转运到医院的患者数量增加了 10.0%(95%CI,6.1-14.2%;P<0.001),但未转运到医院的患者数量也增加了 13.9%(95%CI,8.3-19.8%;P<0.001)。
一项针对前驱性急性心肌梗死症状反应的公众意识宣传活动与胸痛和疑似急性冠状动脉综合征人群中 EMS 使用量的增加有关。宣传活动可能还会导致低危人群中 EMS 使用量的增加。