Analysis on emergency care to the patients with acute myocardial infarction in pre-hospital and in-hospital phase

급성심근경색증 환자에 대한 병원 전 단계와 병원 단계에서의 응급처치 분석

  • Lee, Han-Na (Department of Emergency Medical Service, Seojeong College) ;
  • Cho, Keun-Ja (Department of Emergency Medical Service, Kongju National University)
  • 이한나 (서정대학교 응급구조과) ;
  • 조근자 (공주대학교 응급구조학과)
  • Received : 2013.03.10
  • Accepted : 2013.04.19
  • Published : 2013.04.30


Purpose : The purpose of this study is to provide the basic data to improve pre-hospital phase emergency care for acute myocardial infarction (AMI) patients by analyzing AMI patients' clinical characteristics and emergency care situations. Methods : Data were collected through medical records of 385 AMI patients including ambulance records of 107 AMI patients transferred to the emergency medical center for three and a half years. Results : Regarding emergency care for AMI patients in pre-hospital phase, 47% of the care revealed moderate level or higher, and appropriateness of pre-hospital phase emergency care for cardiopulmonary complaints practiced by paramedics showed statistically significant improvement in recent years (p<.001). The time from onset of symptom to ballooning intervention by 119 emergency services was shorter than that in other cases. However, emergency care by paramedic was mainly basic life support. Conclusion : Since prognosis of AMI shows vast differences depending on prompt detection and medical intervention, cooperation between pre-hospital and in-hospital phase is highly required. 119 paramedics should be trained focusing on the accurate assessment and emergency care, and medical direction should be activated. In addition, regulation on 12-lead EKG, cardiac enzyme analysis, use of analgesics and thrombolytic agents should be legally implemented.


  1. Brieger D, Eagle KA, Goodman SG, Steg PG, Budaj A, White K, et al. Acute coronary syndromes without chest pain, an underdiagnosed and undertreated high-risk group: insights from the global registry of acute coronary events. Chest 2004;126(2):461-9.
  2. Canto JG, Shlipak MG, Rogers WJ, Malmgren JA, Frederick PD, Lambrew CT, et al. Prevalence, clinical characteristics, and mortality among patients with myocardial infarction presenting without chest pain. JAMA 2000;283(24):3223-9.
  3. Jeong MH. Can time delay be shortened in the treatment of acute myocardial infarction?: Experience from Korea acute myocardial infarction registry. Korean J Med 2010;78(5):582-5.
  4. American Heart Association. 2010 AHA guideline highlights for cardiopulmonary resuscitation and advanced cardiovascular life support. Available at:, 2010.
  5. Pollack CV Jr, Antman EM, Hollander JE, American College of Cardiology; American Heart Association. 2007 focused update to the ACC/AHA guidelines for the management of patients with ST-segment elevation myocardial infarction: implications for emergency department practice. Ann Emerg Med 2008;52(4):344-55.
  6. Song YB, Hahn JY, Gwon HC, Kim JH, Lee SH, Jeong MH. The impact of initial treatment delay using primary angioplasty on mortality among patients with acute myocardial infarction: from the Korea acute myocardial infarction registry. J Korean Med Sci 2008;23(3):357-64.
  7. Gyeong Gi provincial fire and disaster headquarters. The present stage of telemedicine system. Available at:, 2012.
  8. Kim H, Lee SW. Impacts of pain on clinical features and outcomes in patients presenting to the emergency department with acute myocardial infarction. J Korean Soc Emerg Med 2005;16(5):511-8.
  9. Schuchert A, Hamm C, Scholz J, Klimmeck S, Goldmann B, Meinertz T. Prehospital testing for troponin T in patients with suspected acute myocardial infarction. Am Heart J 1999;138(1):45-8.
  10. Newman J, Aulick N, Cheng T, Faynor S, Curtis R, Mercer D, et al. Prehospital identification of acute coronary ischemia using a troponin T rapid assay. Prehosp Emerg Care 1999;3(2):97-101.
  11. Sorensen JT, Terkelsen CJ, Steengaard C, Lassen JF, Trautner S, Christensen EF, et al. Prehospital troponin T testing in the diagnosis and triage of patients with suspected acute myocardial infarction. Am J Cardiol 2011;107(10):1436-40.
  12. Jeong JS, Hong KJ, Shin SD, Suh GJ, Song KJ. Evaluation of the appropriateness of prehospital emergency care by 119 rescue services in Seoul metropolitan area. J Korean Soc Emerg Med 2008;19(3):233-44.
  13. National Emergency Medical Center. Result of emergency medicine clinical quality index analysis in 2008. Available at:, 2009.
  14. Lee JH, Sohn JD, Kim SW, Chung TN, Park YS, Park IC. The effect of symptom recognition on pre-hospital delay in patients with acute coronary syndrome. J Korean Soc Emerg Med 2010;21(1):9-18.
  15. Cheon SH, Choe MA. Quality of chest pain according to causal diseases and description of chest pain in patients with coronary artery diseases in emergency departments. Journal of Korean Clinical Nursing Research 2008;14(3):61-72.
  16. National Emergency Management Agency. 2011 Analysis of emergency care. Available at:, 2012.
  17. Ahn HJ. Prehospital treatments of the patients with hypoglycemia by 119 emergency medical technician. Unpublished master's thesis, Kongju National University 2010, Gongju, Korea.
  18. Eun SJ, Kim H, Jung KY, Cho KH, Kim Y. Prospective multicenter evaluation of prehospital care by 119 rescue services. J Korean Soc Emerg Med 2007;18(3):177-89.
  19. Kim YK, Ryoo JH, Moon WS, Chun BJ, Heo T, Min YI. An analysis on the patient transported via 119 system. J Korean Soc Emerg Med 2000;11(2):190-5.
  20. Pack JO, Lee KH, Noh SG, Choi CS. A analysis of prehospital care on the patients transported via 119 system. Korean J Emerg Med Ser 2003;7(1):127-34.
  21. Park JH. Recognition and request for medical direction by 119 emergency medical technicians. Unpublished master's thesis, Kongju National University 2011, Gongju, Korea.
  22. Le May MR, Dionne R, Maloney J, Poirier P. The role of paramedics in a primary PCI program for ST-elevation myocardial infarction. Prog Cardiovasc Dis 2010; 53(3):183-7.
  23. Statistics Korea. Report of death statistics at 2010. Available at:, 2011.
  24. Hwang SO, Lim KS. Cardiopulmonary resuscitation and advanced cardiovascular life support. 4th ed. Seoul: Koonja, 2011. 129.
  25. Lee K. Adequacy analysis of emergency medicine service at scene, transfer phase. Minis-try of Health & Welfare Research Report. 2009
  26. National Emergency Medical Center. 2011 Emergency medicine statistics yearbook. Available at:, 2012.
  27. Lee SJ, Shin SD, Park CB, Song KJ. Effects of using prehospital emergency care by 119 rescue services on outcome of ST-elevation myocardial infarction patients. J Korean Soc Emerg Med 2011;22(1):16-21.
  28. Roh SG. A survey on prehospital emergency medical service for the improvement of acute coronary syndrome assessments. J of Korean Institute of Fire Sci. & Eng 2008;22(3):293-9.
  29. Kim GW, Lee JS, Lee JA. Practical emergency medicine. 4th ed. Seoul: Koonja, 2011.

Cited by

  1. Symptom Clusters in Korean Patients with Acute Myocardial Infarction vol.45, pp.3, 2015,