Posted on November 26, 2002 at 11:54 a.m.

BIRMINGHAM, AL — Nearly half of almost 800,000 heart attack patients drove themselves or were driven to the hospital instead of calling 911, according to a four-year study published in the November 25 online version of Circulation: Journal of the American Heart Association. (The study also will be published in the January 10 print version of the journal.)

“Americans just aren’t using the system like they should,” said John Canto, M.D., author of the study and director of the University of Alabama at Birmingham Chest Pain Center. “But here’s what they absolutely need to know: When you call 911, you may be more likely to be triaged to centers who will administer life-saving treatments like clot-busters, and do so almost two times faster. Why double your risk when it’s as simple as dialing 911?”

Canto said there are several reasons why an ambulance should be called after the onset of a heart attack. First, “Of those patients who die from heart attacks, half die within the first hour,” he said. If the patient does happen to go into cardiac arrest, ambulances are equipped with defibrillators to resuscitate the frozen heart back into rhythm, the only way to restart the heart once it stops.

Second, trained EMS officials may administer some of the first line treatments such as a simple aspirin and also start an IV and hook up an electrocardiogram when a patient is potentially suffering from a heart attack. Third, EMS officials can notify the hospital in advance with critical patient data. Hence, the patient is more likely to arrive at the hospital with diagnosis in-hand, reducing delays in treatment by emergency room doctors. And finally, “Paramedics are smart,” Canto said. “They are more likely to take you to the best cardiac center in the area if they know you are suffering from a heart attack, possibly by-passing other hospitals not specially equipped to handle heart attack patients."

Canto said the findings indicate the need for greater public awareness of both heart attack symptoms and the importance of calling 911 if such symptoms occur. “The message here is if you’re experiencing heart attack symptoms, call 911 immediately. Don’t delay. It could save your life,” he said.

Canto and colleagues studied 772,586 patient records from the National Registry of Myocardial Infarction from June 1994 through March 1998. The NRMI, an observational study of heart attack patients from about 25 percent of the nation’s acute care hospitals, includes information on use of EMS by patients.

Patients using EMS were significantly older, more likely to have had a prior history of heart problems and more likely to have Medicare, Medicaid, HMO or be uninsured as compared to those with private insurance plans. They typically arrived at the hospital sooner, but were also much sicker and more likely to have sustained ventricular tachycardia or fibrillation.

Younger patients were more likely to use self-transport, and the odds of calling 911 increased by 21 percent with each decade of age.

Editor's Note: We are the University of Alabama at Birmingham or UAB on the second reference. We are not to be confused with the University of Alabama, which is a separate, independent campus in Tuscaloosa.