title: Physician perceptions and recommendations about pre-hospital emergency medical services for patients with ST-elevation acute myocardial infarction in Abu Dhabi.
abstract: BACKGROUND
  Physician perceptions about emergency medical services (EMS) are important determinants of improving pre-hospital care for cardiac emergencies. No data exist on physician attitudes towards EMS care of patients with ST-Elevation Myocardial Infarction (STEMI) in the Emirate of Abu Dhabi.
  
  
  OBJECTIVE
  To describe the perceptions towards EMS among physicians caring for patients with STEMI in Abu Dhabi.
  
  
  METHODS
  We surveyed a convenience sample of physicians involved in the care of patients with STEMI (emergency medicine, cardiology, cardiothoracic surgery and intensive care) in four government facilities with 24/7 Primary PCI in the Emirate of Abu Dhabi. Surveys were distributed using dedicated email links, and used 5-point Likert scales to assess perceptions and attitudes to EMS.
  
  
  RESULTS
  Of 106 physician respondents, most were male (82%), practicing in emergency medicine (47%) or cardiology (44%) and the majority (63%) had been in practice for >10 years. Less than half of the responders (42%) were "Somewhat Satisfied" (35%) or "Very Satisfied" (7%) with current EMS level of care for STEMI patients. Most respondents were "Very Likely" (67%) to advise a patient with a cardiac emergency to use EMS, but only 39% felt the same for themselves or their family. Most responders were supportive (i.e. "Strongly Agree") of the following steps to improve EMS care: 12-lead ECG and telemetry to ED by EMS (69%), EMS triage of STEMI to PCI facilities (65%), and activation of PCI teams by EMS (58%). Only 19% were supportive of pre-hospital fibrinolytics by EMS. There were no significant differences in the responses among the specialties.
  
  
  CONCLUSIONS
  Most physicians involved in STEMI care in Abu Dhabi are very likely to advise patients to use EMS for a cardiac emergency, but less likely to do so for themselves or their families. Different specialties had concordant opinions regarding steps to improve pre-hospital EMS care for STEMI.
authors.affiliation: University of Cape Town, Division of Emergency Medicine, Private Bag X24, Belleville 7535, South Africa.
authors.forename: Edward L
authors.initials: EL
authors.lastname: Callachan
authors.affiliation: Institute of Cardiac Sciences, Sheikh Khalifa Medical City, P.O. Box 59100, Abu Dhabi, United Arab Emirates; Institute for Clinical Research and Health Policy Studies, Tufts University School of Medicine, Boston, MA, USA.
authors.forename: Alawi A
authors.initials: AA
authors.lastname: Alsheikh-Ali
authors.affiliation: University of Cape Town, Division of Emergency Medicine, Private Bag X24, Belleville 7535, South Africa.
authors.forename: Stevan
authors.initials: S
authors.lastname: Bruijns
authors.affiliation: University of Cape Town, Division of Emergency Medicine, Private Bag X24, Belleville 7535, South Africa.
authors.forename: Lee A
authors.initials: LA
authors.lastname: Wallis
keywords: Emergency Medical Services; ST Elevation Myocardial Infarction; Survey