title: How do patients with chest pain access Emergency Department care?
abstract: BACKGROUND
  It is important that patients with symptoms of acute coronary syndrome receive appropriate medical care as soon as possible. Little is known about the preadmission actions that patients with chest pain take before arrival at the Emergency Department (ED).
  
  
  OBJECTIVE
  This study aimed to describe the actions of patients with chest pain or pressure after onset of symptoms. What is the first action following onset of symptoms? Who is the first lay or professional person to be contacted? Which steps are taken first? How is the patient transported to the hospital?
  
  
  METHODS
  Consecutive patients, arriving at the ED of two large hospitals in Belgium, were asked additional questions during the initial assessment.
  
  
  RESULTS
  Overall, 35% of 412 consecutive patients with chest pain admitted to the ED were diagnosed with acute coronary syndrome. A total of 57% contacted a GP between symptom onset and arrival at the ED. Only 32% of the patients were transported to the ED by ambulance, 16% drove themselves and 52% arrived by other means of transport (by family, neighbour, GP, public transport).
  
  
  CONCLUSIONS
  In Belgium, the GP is still the first professional to be contacted for most patients. Other patients initially rely on their partner, family or friends when symptoms emerge. Too often, patients with chest pain rely on other transport to get to the ED instead of calling the Emergency Medical Services. This study included only patients who ultimately attended the ED.
authors.affiliation: aDepartment General Practice, KU Leuven bDepartment of Emergency Medicine, University Hospitals Leuven, Leuven cDepartment of Cardiology, Chest Pain Unit, Hospital ZOL Genk, Lanaken, Belgium dDepartment of Family Medicine, University of Maastricht, Maastricht, The Netherlands.
authors.forename: Evie
authors.initials: E
authors.lastname: Van Severen
authors.forename: Robert
authors.initials: R
authors.lastname: Willemsen
authors.forename: Pieter
authors.initials: P
authors.lastname: Vandervoort
authors.forename: Marc
authors.initials: M
authors.lastname: Sabbe
authors.forename: Geert-Jan
authors.initials: GJ
authors.lastname: Dinant
authors.forename: Frank
authors.initials: F
authors.lastname: Buntinx
mesh_terms: D054058:Acute Coronary Syndrome / Q000401:mortality / Q000517:prevention & control*; D000367:Age Factors; D000368:Aged; D001530:Belgium; D002637:Chest Pain / Q000175:diagnosis* / Q000401:mortality* / Q000628:therapy; D003430:Cross-Sectional Studies; D018450:Disease Progression; D042241:Early Diagnosis; D004635:Emergency Medicine / Q000379:methods; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D058005:General Practitioners / Q000706:statistics & numerical data; D006297:Health Services Accessibility / Q000458:organization & administration; D006801:Humans; D008297:Male; D008875:Middle Aged; D011787:Quality of Health Care; D012017:Referral and Consultation / Q000706:statistics & numerical data; D018570:Risk Assessment; D012737:Sex Factors; D011795:Surveys and Questionnaires; D015996:Survival Rate; D061665:Time-to-Treatment