Emergency ambulance transport induces stress in patients with acute coronary syndrome

Reitinger, Agnes; Szusz, R; Hellmich, Christian; Steinlechner, Barbara; Hager, Helmut; Mora, Bruno; Selzer, Michael E.; Hiesmayr, Michael; Kober, Alexander

doi:10.1136/emj.2008.059212

Cited by 10 publications

(7 citation statements)

References 20 publications

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“…In all cases using this option, documentation of the reason for this on the trip must be recorded." 29 A more recent study aimed to test said hypothesis, and measured blood pressure and heart rate, venous levels of epinephrine, norepinephrine, lactate, and visual analogue scores for pain and anxiety in patients with clinical signs of acute coronary syndrome before and after L&S transport. The authors suggest that removing this guideline from the protocol and using entirely objective (as opposed to subjective) criteria would most likely result in even fewer L&S transports.…”

Section: Effect On Patient Outcomementioning

confidence: 99%

“…12 These criteria were cited as the justification for 32% (40/130) of all the L&S transports. 29 A 2011 study demonstrated that increased ambulance speed and acceleration (as occurs during L&S driving) resulted in worsening quality of CPR during patient care. However, they note that it is essentially impossible to implement an entirely objective protocol that covers every single patient transported by ambulance.…”

Section: Effect On Patient Outcomementioning

confidence: 99%

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The Use of Emergency Lights and Sirens by Ambulances and Their Effect on Patient Outcomes and Public Safety: A Comprehensive Review of the Literature

Murray

Kue

2017

Prehosp. Disaster med.

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The benefits of emergency lights and sirens (L&S) use as warning devices by ambulances continue to be a debated topic in Emergency Medical Services (EMS). While the most widely studied aspect of L&S use has been related to their effect on ambulance response and transport times, the literature suggests minimal time savings with more questionable impact on actual patient outcomes. As L&S use has been shown to increase the risk for vehicle crashes, the secondary concern of ambulance design and safety also becomes an important aspect on potential design recommendations that could mitigate the effects of a crash on patients, EMS providers, and the general public. The least studied aspect of L&S use (and probably the most important) is their effect on patient outcomes and quality of medical care during transport. The current evidence suggests no significant improvement on patient outcomes and potential worsening to certain aspects of patient care during transport. The purpose of this review was to examine the current literature regarding ambulance L&S use and the risks they pose to EMS providers, patients, and the general public. In doing so, it will provide sound background for EMS leaders to better develop policies governing the use of L&S by ambulances and promote better research in the patient outcomes effect associated with their use. This review offers some strategies in mitigating the risks associated with L&S use, such as ways to reduce their overall use and modifying other related factors to emergency medical vehicle collisions (EMVCs). Murray B , Kue R . The use of emergency lights and sirens by ambulances and their effect on patient outcomes and public safety: a comprehensive review of the literature. Prehosp Disaster Med. 2017;32(2):209-216.

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Section: Effect On Patient Outcomementioning

confidence: 99%

Section: Effect On Patient Outcomementioning

confidence: 99%

The Use of Emergency Lights and Sirens by Ambulances and Their Effect on Patient Outcomes and Public Safety: A Comprehensive Review of the Literature

Murray

Kue

2017

Prehosp. Disaster med.

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“…Animal models study showed that α-2 antagonist yohimbine lead significant increase in the serum prolactin,[ 19 ] while; nonselective β-antagonist like propranolol inhibits basal prolactin secretion thus; β-blocker produced insignificant effects at physiological prolactin level but it reduced prolactin significantly at pathological and stress induced hyperprolactinemia,[ 20 ] which may explained the effects of antihypertensive agent that commonly used in the cardiovascular complications on serum prolactin measurement in acute coronary syndrome but, there is a little association between high prolactin level and antihypertensive agents and most of the antihypertensive agent in this study were uncontrolled and unremarkable.…”

Section: Discussionmentioning

confidence: 99%

Assessment of serum prolactin levels in acute myocardial infarction: The role of pharmacotherapy

Al-Kuraishy¹,

Al-Gareeb²,

Awad³

et al. 2016

Indian J Endocr Metab

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Background:Hyperprolactinemia may reflect neuroendocrine stress reaction against acute coronary syndromes.Aim:The aim of the present study was evaluation of the serum prolactin level in the acute myocardial infarction (MI) regarding the current pharmacotherapy in management of MI.Setting and Design:Cross-sectional clinical based study.Subjects and Methods:This cross-sectional clinical study involved all patients with acute MI in a coronary care unit, a total number of 44 patients (45% males and 55% females) with age ranged from 40 to 75 years. A full history for modifiable risk factors and current therapy with aspirin, clopidogrel and or metformin, all patients are nonsmokers. The anthropometric measurements; for estimations of body mass index (kg/m2), electrocardiography was obtained. Fasting blood samples were taken in the morning from all patients and the sera used for estimations of routine investigation and determination of ischemic cardiac biomarkers like cardiac troponin I (cTnI) and serum prolactin level.Results:This study shows a significant increase in the serum prolactin in acute MI as compared with the control. In acute MI serum cTnI elevation was correlated with serum prolactin increments. In metformin-treated group, there was a lowest prolactin serum level.Conclusions:Serum prolactin level increased in acute MI, and positively correlated with cardiac troponin level and reflects underlying cardiovascular complications.

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“…Acute MI is a medical emergency that requires immediate professional assistance in a health care institution [14]. The context of hospital referral and process of emergency treatment may influence stress perception of MI patients [15][16][17].…”

Section: Introductionmentioning

confidence: 99%

Perception of a hectic hospital environment at admission relates to acute stress disorder symptoms in myocardial infarction patients

Meister

Weber

Princip

et al. 2016

General Hospital Psychiatry

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Objective Hospital crowding is a public health problem that may impact on the quality of medical treatment and increase the risk of developing traumatic stress, e.g., after myocardial infarction (MI). This study examines whether subjective appraisal of crowding at hospital admission due to MI is associated with acute stress disorder (ASD) symptoms. Method We investigated 102 consecutive patients with acute MI within 48 h after having reached stable circulatory conditions. The appraisal of crowding was measured by the retrospective assessment of the perception of a hectic hospital environment at admission. Furthermore, patients completed the Acute Stress Disorder Scale to rate the psychological stress reaction. Results The perception of a hectic hospital environment was associated with the development of ASD symptoms (r= 0.254, P= .013) independently of demographic, peritraumatic and medical factors. Post hoc analysis revealed associations with dissociative (r= 0.211, P= .041), reexperiencing (r= 0.184, P= .074) and arousal (r= 0.179, P= .083) symptoms. Conclusion The findings suggest that, besides objective circumstances, the way hospital admission due to MI is perceived by the patient may influence the development of MI-triggered ASD symptoms. The psychological and physiological long-term outcomes of the perception of a hectic hospital environment and the role of preventive interventions need further examination. ABSTRACTObjective: Hospital crowding is a public-health problem that may impact on the quality of medical treatment and increase the risk of developing traumatic stress, e.g. after myocardial infarction (MI). This study examines whether subjective appraisal of crowding at hospital admission due to MI is associated with acute stress disorder (ASD) symptoms. Method:We investigated 102 consecutive patients with acute MI within 48 hours after having reached stable circulatory conditions. The appraisal of crowding was measured by the retrospective assessment of the perception of a hectic hospital environment at admission.

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Emergency ambulance transport induces stress in patients with acute coronary syndrome

Abstract: Emergency ambulance transportation induces a rise in plasma catecholamine levels and therefore stress in patients with acute coronary syndrome, but does not result in cardiac shock as lactate levels and haemodynamic parameters remain normal.

Cited by 10 publications

References 20 publications

The Use of Emergency Lights and Sirens by Ambulances and Their Effect on Patient Outcomes and Public Safety: A Comprehensive Review of the Literature

The Use of Emergency Lights and Sirens by Ambulances and Their Effect on Patient Outcomes and Public Safety: A Comprehensive Review of the Literature

Assessment of serum prolactin levels in acute myocardial infarction: The role of pharmacotherapy

Perception of a hectic hospital environment at admission relates to acute stress disorder symptoms in myocardial infarction patients

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