RECOGNITION OF HEART ATTACK SYMPTOMS: A COMMUNITY BASED INITIATIVE TO DECREASE DELAYS IN PRESENTATION TO HOSPITAL
St George Cardiovascular Outcomes Group (COG), The St George and St George Private Hospitals, Sydney, New South Wales.
Failure to recognise symptoms of myocardial ischaemia has been well documented as a factor in the delay of patients presenting to hospital for definitive treatment of acute myocardial infarction. Community focused information programs have been implemented in the St George area for the past four years to address this issue. A 1998 Heart Week initiative launched new strategies to augment existing activities. Previous evaluation has demonstrated that national media campaigns directed at decreasing pre-hospital delays have largely been unsuccessful. COG postulated that locally driven initiatives may have the potential to deliver this important information in a more tangible, accessible form to our local community. A multi-faceted approach utilising local media, a unique logo and slogan, street banners and personalised risk assessment given at community groups, and the local Rugby League club was implemented. This project required collaboration of Emergency and Cardiovascular services in the public and private sector, the local newspaper, council, community groups and Rugby League Club. Audits of presentation to hospital of patients receiving thrombolytic therapy for acute myocardial infarction were performed, calculating time to presentation as being from the patient's self report of onset of symptoms to the time the patient was logged into the Emergency Department Information System (EDIS). In 1995 the median time to presentation was 198 mins (n=57), 110 mins (n=75) in 1997 and 83.5 (n=81) mins in 1998.
Conclusion: We have demonstrated a decrease in pre-hospital delays in the St George area, although it is impossible to attribute these directly to local initiatives, it is likely these contribute to national medial campaigns and also begs the question of whether evaluation of these campaigns have been performed too close to the intervention.
