Читать книгу Emergency Medical Services - Группа авторов - Страница 221

In the United States, someone experiences a myocardial infarction every 26 seconds, and alarmingly, the disease claims one life each minute [1]. Heart disease accounts for twice as many deaths in the United States as are attributed to unintentional injuries, which has major implications for EMS systems [2]. About half of individuals who suffer acute myocardial infarctions (AMI) are transported to the hospital by EMS, and many more patients call EMS for help because they are experiencing chest pain [3].

The prehospital management of chest pain has improved with better clinical examination, earlier administration of effective medications, and the broad use of 12‐lead ECGs to detect acute coronary syndromes (ACS) and myocardial infarction more accurately before arrival in the emergency department (ED) [4]. Because more rapid reperfusion during acute myocardial infarction improves heart function and patient survival, EMS and health care systems have focused on developing strategies to identify chest pain patients with myocardial infarction quickly and to provide effective treatment while transporting them directly to definitive care [5–7].

The goals of management for patients with chest pain include rapid identification of the patient with ACS, relief of symptoms, and transport to an appropriate hospital. This chapter will cover the assessment and treatment of patients with the chief complaint of chest pain and will focus on the scientific basis for prehospital medical care of those patients. It will also review common conditions that can cause chest pain.