Ambulances: The difference between life and death?

Study finds only 35% of patients used them when presented with symptoms of heart attack 

by Ng Jing Yng, TODAY, 1 Jun 2012

A study here has found that patients who encounter acute heart attacks are not calling for ambulances, resulting in a delay in receiving medical help. The study, the findings of which were published in the Internal Medicine Journal last year, surveyed 252 heart attack patients at the National University Hospital (NUH).

The study found that only 35 per cent of these patients used emergency medical services when presented with symptoms of a heart attack.

Some 98 patients took their own transport to the hospital, while another 22 per cent sought assistance from their general practitioner (GP) first.

For those who did not call for an ambulance, the period between the onset of symptoms and receiving medical help was prolonged by an average of 82 minutes, according to the study.

National University Heart Centre registrar Tan Li Ling, who led the study, said: "There is a need to educate the public on the symptoms of a heart attack as patients might not use the emergency medical service when they do not recognise the symptoms."

She added that greater awareness of the benefits of using an ambulance was needed. For instance, in the case of a life-threatening heart attack, paramedics and equipment like defibrillators are on hand to provide prompt treatment on the spot, she said.

GPs TODAY spoke to said educating patients could be challenging. For one, heart attack symptoms may not be easily recognisable. Dr Kevin Chua of Drs Chua & Partners said: "The symptoms of a heart attack vary and it is not clear cut. Hence, patients might turn to their GP if they see the symptoms as something mild."

He encounters patients suffering heart attacks once every few months and refers them to the hospital after assessing their condition.

The researchers said the tendency to brush off symptoms could be cultural, as the findings are in line with overseas studies which have found that Asian patients were more likely to not call for emergency medical help. This may also be the case when it comes to older patients, they added.

The researchers noted some patients may assume they could reach the hospital faster in their own cars.

However, the study would have to be expanded to be more representative as it involved a relatively healthy group of participants with a low mortality rate and this was not an accurate reflection of NUH's heart attack patients, they said.