St-Elevation Myocardial Infarction (STEMI) Supported By National Emergency Medical Services (EMS): Prospective Study Over A 06-Month Period From January 01st To June 30th, 2023

Introduction: ST-elevation myocardial infarction (STEMI) remains a major public health issue worldwide. The pre-hospital care by SMUR unit (medical emergency and resuscitation services) occupies an important place. The main objective of this study was to evaluate the quality of STEMI management by the Emergency Medical Services (EMS) in Senegal. Methodology: It is a prospective, descriptive and analytical study over a period of 06 months from January 1st, 2023 to June 30th, 2023. All STEMI supported by the national EMS of Senegal were included in this study. Results: We included 82 patients, which represented 0.01% of the EMS activity during this period. The sex ratio (M/F) was 1.9. The average age was 60 years. The interventions of the EMS in Dakar were the most important (82.3%). The most frequent mode of intervention was the search for a place and then transport (56.1%). The average number of structures contacted by the regulation in the search for a place was 2. EMS was mainly requested between 08:00 and 20:00 in 73.2% of cases. The majority of interventions (92.3%) were performed in medical facilities. The average time between EMS call and SMUR arrival was 91 min. The average time for SMUR teams to respond was 35,2 min. The average time to transport the patient from the site of the intervention to the cardiology department was 48,8 min. The average time between emergency department call and admission to cardiology was 176 min. Pre-hospital administration of anti-platelet therapy was effective in almost all patients (97.6%). The thrombolysis was mostly pre-hospital (31.7%) with a success rate of 57.7%. Revascularization by percutaneous coronary intervention (PCI) was performed in 40 patients (48.7%). We had noted 5 deaths at the sites. Conclusion: The management of STEMI by the national medical service requires an improvement in deadlines to reduce morbidity and mortality.