Survey: Americans underuse 911 services in response to heart attack symptoms

July 12, 2000
Web posted at: 12:24 p.m. EDT (1624 GMT)

From staff reports

ATLANTA (CNN) -- Most Americans readily will telephone 911 to summon medical help when they fear someone else is having a heart attack, but many are reluctant to make the call when they have the same symptoms, researchers reported Tuesday. That hesitance could be deadly.

The findings were reported in Circulation: Journal of the American Heart Association. They were based on a national survey designed to assess the use of 911 emergency medical services (EMS).

"With this study, we wanted to determine if community members realized the benefit of using EMS during a cardiac emergency," said study leader N. Clay Mann, an associate professor at the University of Utah School of Medicine in Salt Lake City.

Of the 1.1 million Americans who experience heart attacks each year, more than half die before reaching a medical facility. But early treatment with clot busting drugs and other therapies can help reduce the chance of death, Mann said.

The American Heart Association strongly advocates calling 911 immediately when a cardiac emergency is detected, said AHA president Dr. Rose Marie Robertson.

"Our 'Operation Heartbeat' initiative, which is being launched in more than 100 communities, helps provide tools to get the 'call 911' message out to the general public," she said. "This study provides more evidence that the public needs to hear this message."

Mann estimated that the risk of heart attack-related death can be reduced 25 percent when treatment is given soon after the onset of acute symptoms such as chest pain, discomfort in the left arm, jaw or neck, sweating, nausea or weakness.

"Unfortunately, only a fraction of patients who are eligible for these treatments receive therapy in time," he said, largely because they don't get to the hospital quickly enough.

According to the study by Mann’s team, the people most likely to call EMS were older, lived alone, had a history of heart disease, or lived in a community with ambulance service supported by taxes.

Mann's associates randomly telephoned 962 people in 20 communities across the United States and asked, "If you thought someone was having a heart attack, what would you do?"

Two optional responses were call 911 or an ambulance, or drive the person to a hospital.

On average, 89 percent of the respondents from each community said they would call 911 if they witnessed a person having a heart attack. About 8 percent said they would consider driving someone with possible heart-attack symptoms to the hospital.

But when the team studied the hospital records in the same communities, they found a discrepancy.

Of 875 people who came to the emergency room with chest pain, about 60 percent had been driven there by a family member or friend.

Some of those suffering chest pain postponed calling EMS or going to the hospital because they took aspirin, or believed their symptoms were due to heartburn and took antacid medication, he said. Others put off calling EMS after speaking to their doctor.

"It is problematic that communication with a doctor decreased EMS use," Mann said. "Speaking with a doctor may have reduced patient anxiety in a way that made EMS transport seem optional."

The study was conducted at the Oregon Health Sciences University department of emergency medicine in Portland.

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American Heart Association

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