Chest pain suggestive of a heart attack (1) is a common reason for calling an ambulance, and for being transferred to the Emergency Department. However, only about 1 in 5 patients turn out to have this condition.
In a recent research study called ACCESS, researchers from the local Emergency Department worked with ambulance teams across the Grampian region to evaluate the ability of Paramedics to rule in and rule out a heart attack at the point of first contact in the pre-hospital environment. They were testing a brief structured clinical assessment tool that encompassed routine clinical information, an ECG (heart tracing) and a portable blood test that detects damage to heart muscle.
Analysis of the data obtained in the ambulances demonstrated that Paramedics were very good at discriminating risk in this group of patients, but not to the level of being able to rule out a heart attack with sufficient confidence to not transfer patients to hospital.
Dr Jamie Cooper, Consultant in Emergency Medicine, told us that, “The results were important, but more work needed to be done, particularly with regard to the pre-hospital evaluation of newer and more sensitive markers of heart muscle damage, now becoming available as portable tests.”
For those interested in the details, this is the link to the article that is open access : https://www.annemergmed.com/article/S0196-0644(21)00060-3/fulltext