An Insight on Prehospital Delay and Ambulance Usage in Acute Myocardial Infarction

Abstract

In acute myocardial infarction (AMI), the time elapsed between the onset of symptoms and definitive care plays a crucial role in the mortality and morbidity of a victim. The symptom onset to reperfusion therapy comprises prehospital time and hospital time. There are evidence-based international guidelines to minimize hospital time. However, reducing prehospital time and developing strategies to prevent the delay necessitate a thorough understanding of the underlying causes. In the event of an emergency, calling an ambulance can assist cut down on transportation delays, which cuts down on prehospital time and its effects. Aim of this review is to analyze the relationship between ambulance service utilization and prehospital delay in AMI patients. Studies that reported prehospital delay and ambulance usage were collected with a search on the expression “prehospital delay in AMI” in combination with “ambulance usage.” These studies were from around 15 countries on six continents and were analyzed and summarized in this review. The extracted data expressed under six headings: emergency medical service (EMS) as a first medical contact, ambulance disuse, shorter prehospital delay, no or poor EMS system, predictors of ambulance use in AMI, and efforts to reduce prehospital delay. In AMI, using an ambulance is advisable for early diagnosis and swift transport to a definitive care center. However, ambulance services are frequently unavailable or underutilized.