It was Monday, June 20, 2016, and Mike Bertrand, 63, was helping an elderly friend prepare for a move. Mike and his son Mathew, 28, were packing boxes and loading them into a van. Although in good physical condition, Mike quickly felt tired and needed to sit down and take a break. He began to feel strange. He told his son there was something wrong and, at first, thought he should go home.
Mike then realized the feeling was serious and instead asked his son to drive him to the hospital, but he never thought he was having a heart attack. A retired millwright, Mike was active his entire life and always maintained his weight within 10 pounds. On the way to the hospital, Mike began to feel worse and calmly asked his son to call 911 to ask for an ambulance to meet them en route. They continued to drive and soon saw the ambulance coming, but it was on the wrong side of the road. Mathew ran a red light and pulled a U-turn in order to meet the ambulance.
Once Mike was in the ambulance, the paramedic quickly determined that he was having a heart attack. Mike was surprised to hear this diagnosis. The paramedic gave him an injection of nitroglycerin and called The Ottawa Hospital’s Civic campus to alert the emergency department that there was a patient arriving who was in need of immediate attention. When Mike arrived at the hospital, the surgeon and his team were waiting.
Mike is making a full recovery, but he says he was lucky to meet the ambulance on the road, receive immediate treatment on the way to the hospital and have the surgeon prepped and ready to do the procedure upon his arrival. For Mike, riding in the ambulance the rest of the way to the hospital was the difference between life and death.
A week before the move, Mathew had enjoyed Chinese food with his wife and in-laws. After the meal, he opened his fortune cookie and read a slip of paper that said “You’re going to be somebody’s hero.” Mathew helped get his father to an ambulance quickly and, ultimately, may have contributed to saving his life. Mathew undoubtedly is a hero.
When to call an ambulance
Strokes and heart attacks are time-sensitive conditions for which calling an ambulance is recommended. CIHI recently released its Snapshot Ambulance Use for Time-Sensitive Conditions: Stroke and Heart Attack, written in consultation with the Heart and Stroke Foundation. This brief analysis shows the proportion of stroke and heart attack patients who arrive at the hospital by ambulance and outlines characteristics of those patients who don’t use an ambulance to get to the hospital.
Factors that are linked to being more likely to use an ambulance for stroke and heart attack, by decreasing degree of influence, are older age, living further from the hospital, living in a lower income–quintile neighbourhood and being female.
Factors that are linked to being less likely to use an ambulance for stroke and heart attack, by decreasing degree of influence, are younger age, living closer to the hospital, living in a higher income–quintile neighbourhood and being male.
In 2014–2015 in Canada (excluding Quebec), more than 34,000 patients were admitted to hospital for a stroke and more than 75,000 for a heart attack. Despite recommendations that all patients experiencing signs of stroke or heart attack should call an ambulance, 1 in 3 stroke patients and 1 in 2 heart attack patients did not arrive at the hospital by ambulance.
Overall, stroke and heart attack patients who were less likely to arrive at the hospital by ambulance were
- Younger (45 and under)
- Living closer to the hospital
- Residing in a higher-income neighbourhood
The influence of these factors was stronger for heart attack patients. Even after accounting for disease severity (adjusting for comorbidities, number of interventions, length of stay and death), these characteristics remained significant.
Recommendations across Canada encourage anyone with signs of stroke or heart attack to call an ambulance. Paramedics can assess and manage the patient, notify the hospital and transport the patient to the hospital best equipped to treat him or her.
The Heart and Stroke Foundation says warning signs of a heart attack can vary from person to person and may not always be sudden or severe. Although chest pain or discomfort is the most common symptom of a heart attack in both men and women, some people will not experience chest pain at all, while others will experience only mild chest pain or discomfort. Some may experience a single symptom, while others experience a combination.
If you ever suspect that you or someone you love is having a heart attack or stroke, call an ambulance. You, too, could be somebody’s hero.