• L Lozzi, S Carstensen, H Rasmussen, and G Nelson.
• Cardiology Department, Royal North Shore Hospital, Sydney, New South Wales, Australia. llozzi@gmp.usyd.edu.au
• Intern Med J. 2005 Nov 1;35(11):668-71.

BackgroundStudies from overseas indicate that patients with acute myocardial infarction (AMI) symptoms often fail to use the emergency services as recommended, thereby depriving themselves from life-saving treatment in case of cardiac arrest and delaying the time to myocardial reperfusion in the presence of a coronary occlusion.AimsTo compare patients brought in by ambulance to those not brought in by ambulance and to question why some patients do not use the emergency services when presenting to hospital with AMI symptoms.MethodsProspective interview and follow up of consecutive patients presenting with AMI symptoms to the emergency department of a tertiary hospital in a metropolitan area within a 1-month period.ResultsOf the 215 patients presenting to the emergency department, 113 (53%) arrived by private transportation. Sixty (53%) of these felt their symptoms did not warrant calling the ambulance, 17 (15%) had first consulted their general practitioner. The private transport group accounted for 28% of documented AMI.ConclusionsA large proportion of patients with AMI symptoms refrain from calling the emergency services because they do not consider themselves critically ill. Education programmes appear to be warranted because more appropriate use of emergency services will save lives.

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