Evidence map›Paper›PMID 26759642›Full record

ReviewThe western journal of emergency medicine2015

Chest Pain of Suspected Cardiac Origin: Current Evidence-based Recommendations for Prehospital Care.

P Brian Savino, Karl A Sporer, Joe A Barger, John F Brown, Gregory H Gilbert, Kristi L Koenig, Eric M Rudnick, Angelo A Salvucci

Abstract readComparative StudyReview
PubMed Full text at PMC Publisher
In one paragraph

Review in The western journal of emergency medicine, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Guideline
  2. Medical ID use by international patients with Aspirin-Exacerbated Respiratory Disease.Allergy, asthma, and clinical immunology : official journal of the Canadian Society of Allergy and Clinical Immunology · 2023
    Article
  3. Article
  4. Article
  5. Review
  6. Variations in Cardiac Arrest Regionalization in California.The western journal of emergency medicine · 2018
    Article
  7. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

P Brian SavinoUniversity of California, San Francisco, Department of Emergency Medicine, San Francisco, California.
Karl A SporerEMS Medical Directors Association of California, California.
Joe A BargerEMS Medical Directors Association of California, California.
John F BrownEMS Medical Directors Association of California, California.
Gregory H GilbertEMS Medical Directors Association of California, California.
Kristi L KoenigEMS Medical Directors Association of California, California; University of California, Irvine, Center for Disaster Medical Sciences, Orange, California.
Eric M RudnickEMS Medical Directors Association of California, California.
Angelo A SalvucciEMS Medical Directors Association of California, California.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionIn the United States, emergency medical services (EMS) protocols vary widely across jurisdictions. We sought to develop evidence-based recommendations for the prehospital evaluation and treatment of chest pain of suspected cardiac origin and to compare these recommendations against the current protocols used by the 33 EMS agencies in the state of California.

methodsWe performed a literature review of the current evidence in the prehospital treatment of chest pain and augmented this review with guidelines from various national and international societies to create our evidence-based recommendations. We then compared the chest pain protocols of each of the 33 EMS agencies for consistency with these recommendations. The specific protocol components that we analyzed were use of supplemental oxygen, aspirin, nitrates, opiates, 12-lead electrocardiogram (ECG), ST segment elevation myocardial infarction (STEMI) regionalization systems, prehospital fibrinolysis and β-blockers.

resultsThe protocols varied widely in terms of medication and dosing choices, as well as listed contraindications to treatments. Every agency uses oxygen with 54% recommending titrated dosing. All agencies use aspirin (64% recommending 325 mg, 24% recommending 162 mg and 15% recommending either), as well as nitroglycerin and opiates (58% choosing morphine). Prehospital 12-Lead ECGs are used in 97% of agencies, and all but one agency has some form of regionalized care for their STEMI patients. No agency is currently employing prehospital fibrinolysis or β-blocker use.

conclusionProtocols for chest pain of suspected cardiac origin vary widely across California. The evidence-based recommendations that we present for the prehospital diagnosis and treatment of this condition may be useful for EMS medical directors tasked with creating and revising these protocols.

Indexed as

Adrenergic beta-AntagonistsAnalgesics, OpioidAngina PectorisAspirinCaliforniaClinical ProtocolsElectrocardiographyEmergency Medical ServicesEvidence-Based PracticeFibrinolytic AgentsHealth PolicyHumansMorphineNitroglycerinOxygenPractice Guidelines as TopicAdrenergic beta-AntagonistsAnalgesics, OpioidAspirinFibrinolytic AgentsMorphineNitroglycerinOxygenVasodilator Agents

Identifiers

PMID26759642
PMCPMC4703143

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.