Evaluation Of Pre-hospital Medical Emergency Telephone Guidance For The Treatment Of Coronary Heart Disease

Objective:Until the patient is transported to the hospital from an emergency situation,the whole process of the out-of-hospital rescue and treatment(also known as pre-hospital medical care)is done through self-help or assisted aid.Emergencies can range from all kinds of scenarios,including sudden illnesses,accidents and other situations that requires immediate medical assistance.The emergency medical dispatch is the whole process to guide pre-hospital medical care after receiving the information assessing each emergency scenario.A good quality emergency dispatch consists of responsiveness and a rich professional experience.However even with advanced medical equipment and skilled medical personnel,the distance,traffic congestion and other unforseen circumstances delays the arrival of the personnel to the emergency scene.Emergency dispatchers who received a distress call quickly makes effort understand the situation and assess the severity of the patient's condition,and if trained with professional medical knowledge,can also provide telephone assisted medical advice and guidelines while the dispatched emergency personnel is arriving to the scene,thereby improving the effectiveness of the pre-hospital medical care.With the aging population in China the chances of coronary heart disease in individuals are exacerbated,and can therefore seriously harm the overall health of the population,with the mortality rate in the country rising every year.The purpose of this study was to assess the effectiveness of the the pre-hospital care for coronary heart disease(acute coronary syndrome,chronic coronary disease)in patients with emergency dispatchers who provided medical guidance through the telephone to the patient prior to the arrival of the emergency personnel.Methods:From January to June of 2012,the emergency center in Dalian for coronary heart disease had 210 patients.Two groups were established.Group A consists of 80 cases where emergency dispatchers did not provide medical advice by phone.Group B consists of the remaining 130 cases where emergency dispatchers dispatchers did provide medical advice by phone.The emergency response time,on-site treatment time,arrival remission rate,symptom relief rate after treatment and family satisfaction of the pre-hospital care were analyzed and summarized after the treatment.Results:The average index for Group A(the control group)is as follows: emergency response time of 14.6 � 8.5 min,on-site treatment time of 21.27 � 11.9 min,arrival remission rate of 23.7%,after-treatment symptom relief rate of 61.2% and the satisfaction of the family with the pre-hospital care is 82.5%.The average index for Group B(the study group)is as follows: emergency response time of 15.7 � 9.5 min,on-site treatment time of 15.43 � 5.7 min,arrival remission rate of 33.8%,after-treatment symptom relief rate of 94.9% and the satisfaction of the family with the pre-hospital care is 97.5%.Between both groups,when compared to the on-site treatment time,the arrival remission rate / symptom relief rate after treatment and family satisfaction showed statistically significant differences(P < 0.05).The emergency response time showed no significant difference(P > 0.05).Conclusion:For emergency patients,the use of telephone guidance in pre-hospital medical care can signficantly improve the remission rate of cononary heart disease,reduce on the on-site treatment time,reduce the incidence of cardiovascular adverse events and improve the overall treatment rate of the pre-hospital care as well as the satisfaction of the patients and their families towards the care.