Medical Telephone Triage of Emergency Calls for Thoracic Pain

Overview

Thoracic pain is the main symptom of acute coronary syndrome (ACS), urgent and serious illness. Whereas hospital mortality decreased until reaching 10%, out-of-hospital mortality remains high: half of the deaths occur during the first two hours. The benefit of an early diagnosis of ACS in term of morbidity and mortality is well established. Identification of the coronary origin of a thoracic pain by the telephone triage physician of the pre-hospital emergency service (SAMU) leads to the sending of a physician staffed ambulance (UMH) and is thus a key element of the prognosis. The aim of the study is to build a telephone predictive score of ACS at the triage of calls for non traumatic thoracic pain. The separate analysis of the questionnaires by sex will authorize the validation of a unique score or two distinct scores for men and women.

In France, approximately 30% of the calls for thoracic pain associated with an ACS do not benefit from the sending of an UMH. Our assumption is that this situation could be improved if telephone triage physicians were guided by recommendations or consensual algorithms of decision. The telephone triage doctor will manage a single questionnaire with the patient, with demographic and simple clinical data. The construction of the score will be done by the analysis of these data confronted with the final diagnosis (effective ACS or not). The effective existence of an ACS among patients with thoracic pain will be affirmed by an expert committee after collection of the intra-hospital patient's data and the follow-up at one month.

Conditions

Eligibility