A study published in the January issue of the American Heart Journal suggests that patients suffering from chest pain get definitive care more quickly when they call an ambulance, than they do when they take private transportation to the emergency room. The authors reached this conclusion by analyzing data from the REACT study (a trial of community education intervention, conducted in 20 US cities.)
While patients who took private transportation arrived at the hospital an average of 4 minutes earlier than those who called an ambulance (35 minutes vs 39 minutes,) those who called an ambulance received both initial care and definitive care muchmore quickly than those who did not. Authors concluded that patients who use private transportation in order to get to the hospital more quickly may in fact be delaying their treatment.
What's going on here?
It turns out that, on average, driving yourself (or having yourself driven) to the hospital does indeed get you there more quickly than calling for - and waiting for - an ambulance. Unfortunately, this initial time-saving does not translate into earlier therapy. Why is this?
There are at least two reasons. First, EMS personnel begin the medical evaluation the moment they arrive on the scene. If you are having a heart attack (myocardial infarction,) chances are they will know that rapidly, and will begin initiating therapy right away, well before you arrive at the hospital. This early therapy, while not definitive, does stabilize the situation. (Here, the word "stabilize" should be read as "buying time.")
Secondly, when you do arrive at the emergency room, being wheeled directly into a treatment room by EMS personnel - who have radioed ahead with all the details of your condition - has far more impact on mobilizing therapy than showing up yourself in the crowded ER reception area, and trying to talk your way into a treatment room.
All of this is extremely important if you are indeed having a heart attack. Study after study has shown that the most important factor in determining outcome after the onset of a heart attack is the time to therapy. The sooner therapy is begun - and the sooner the occluded coronary artery is re-opened - the better the chance of survival. Minutes matter. So if you think you are having a heart attack, in most US cities calling an ambulance is a better choice than making your own way to the hospital.
