title: Management of non-traumatic chest pain by the French Emergency Medical System: Insights from the DOLORES registry.
abstract: BACKGROUND
  The early recognition of acute coronary syndromes is a priority in health care systems, to reduce revascularization delays. In France, patients are encouraged to call emergency numbers (15, 112), which are routed to a Medical Dispatch Centre where physicians conduct an interview and decide on the appropriate response. However, the effectiveness of this system has not yet been assessed.
  
  
  OBJECTIVE
  To describe and analyse the response of emergency physicians receiving calls for chest pain in the French Emergency Medical System.
  
  
  METHODS
  From 16 November to 13 December 2009, calls to the Medical Dispatch Centre for non-traumatic chest pain were included prospectively in a multicentre observational study. Clinical characteristics and triage decisions were collected.
  
  
  RESULTS
  A total of 1647 patients were included in the study. An interview was conducted with the patient in only 30.5% of cases, and with relatives, bystanders or physicians in the other cases. A Mobile Intensive Care Unit was dispatched to 854 patients (51.9%) presenting with typical angina chest pains and a high risk of cardiovascular disease. Paramedics were sent to 516 patients (31.3%) and a general practitioner was sent to 169 patients (10.3%). Patients were given medical advice only by telephone in 108 cases (6.6%).
  
  
  CONCLUSIONS
  Emergency physicians in the Medical Dispatch Centre sent an effecter to the majority of patients who called the Emergency Medical System for chest pain. The response level was based on the characteristics of the chest pain and the patient's risk profile.
authors: Service de cardiologie, université Paris VII, CHU Lariboisière, AP-HP, 2, rue Ambroise-Paré, 75475 Paris cedex 10, France. Electronic address: stephane.manzosilberman@lrb.aphp.fr.
authors: Stéphane
authors: S
authors: Manzo-Silberman
authors: Service d'aide médicale urgente de Lille, Lille, France.
authors: Nathalie
authors: N
authors: Assez
authors: Service d'aide médicale urgente de Paris, université Paris Descartes-Paris V, CHU Necker-enfants malades, AP-HP, Paris, France.
authors: Benoît
authors: B
authors: Vivien
authors: Service d'aide médicale urgente 77, urgence-réanimation, hôpital Marc-Jacquet, Melun, France.
authors: Karim
authors: K
authors: Tazarourte
authors: Service d'aide médicale urgente, hôpital Côte-Basque, Bayonne, France.
authors: Tarak
authors: T
authors: Mokni
authors: Service d'aide médicale urgente, CHU Toulouse 3, Toulouse, France.
authors: Vincent
authors: V
authors: Bounes
authors: Service d'aide médicale urgente de Paris, université Paris Descartes-Paris V, CHU Necker-enfants malades, AP-HP, Paris, France.
authors: Agnès
authors: A
authors: Greffet
authors: Service d'aide médicale urgente, CHU Toulouse 3, Toulouse, France.
authors: Vincent
authors: V
authors: Bataille
authors: Société française de cardiologie, Paris, France.
authors: Geneviève
authors: G
authors: Mulak
authors: Service d'aide médicale urgente de Lille, Lille, France.
authors: Patrick
authors: P
authors: Goldstein
authors: Service d'aide médicale urgente, CHU Toulouse 3, Toulouse, France.
authors: Jean Louis
authors: JL
authors: Ducassé
authors: Inserm U 970, département de cardiologie, centre d'expertise de la mort subite, université Paris-Descartes, hôpital européen Georges-Pompidou, AP-HP, Paris, France.
authors: Christian
authors: C
authors: Spaulding
authors: Service d'aide médicale urgente, CHU Toulouse 3, Toulouse, France; Inserm UMR 1027, University Paul Sabatier Toulouse III, Toulouse, France.
authors: Sandrine
authors: S
authors: Charpentier
mesh_terms: D002637:Chest Pain / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D004630:Emergencies; D004632:Emergency Medical Services; D005260:Female; D005602:France; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012042:Registries; D014218:Triage
keywords: Acute coronary syndrome; Centre d’appel; Chest pain; Douleur thoracique; Emergency; Hotline; Syndrome coronaire aigu; Triage; Urgences