Gender Delay in Emergency Medical Services

Abstract

Patients who have symptoms suspicious for an acute coronary syndrome (ACS) should be evaluated as soon as possible after symptom onset if for no other reason than to identify those with ST elevation myocardial infarction (STEMI) who can benefit from timely reperfusion therapy. In our society, we expect that all patients, regardless of individual characteristics (eg, age, gender, race, socioeconomic status, and neighborhood location), should be treated equally. Therefore, when an analysis of emergency medical services (EMS) run sheets in a large urban settings, such as Dallas County, Tex, leads to the conclusion that women have 50% greater odds of being delayed in the EMS setting compared with men, significant attention should focus on the validity of the results and their public health/societal implications. Article see p 9 In this issue, Concannon et al1 conducted a retrospective cohort study of 5887 patients with suspected cardiac-related symptoms evaluated by EMS providers from 10 municipalities in Dallas County, Tex, during 2004. They examined associations between a variety of patient/EMS run characteristics and the elapsed EMS time from patient call to hospital arrival divided into 3 intervals (response time, on-scene time, and transport time). Median elapsed time in EMS for all patients as a group was 34 minutes. The authors used a variety of multiple logistic regression models to identify predictors of average elapsed time in EMS, adjusting for distance traveled, onset time, patient vital signs, age, race, and neighborhood socio-economic composition. Although women were delivered to the hospital an …