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Published: Monday, 1/10/2005

Not quite ready for 911? Maybe it's time for '811'

Would a kinder, gentler version of the 911 emergency telephone system save more lives from heart attacks and brain attacks (strokes) than the current system?

Some emergency medicine experts think an "811" system could address one factor that makes people with heart attack and stroke symptoms delay getting help in a life-or-death-situation.

A call to 911 now triggers an all-out response that creates a real scene: Sirens and flashing lights; emergency personnel rushing in with equipment; neighbors, co-workers, and bystanders gathering to gawk and speculate.

And what if it's a false alarm? Will people be whispering and snickering the next day? "Joe really flipped out. All that fuss for a belly ache!"

Never mind that Joe did exactly what medical experts recommend. He called for help when symptoms that could be a heart attack first appeared. It is not flipping out. Medically-informed people do it, including the likes of Vice President Dick Cheney, who has made emergency room visits that were false alarms rather than heart attacks.

Concerns about embarrassment and triggering the 911 system needlessly are among a number of reasons people with life-threatening illnesses delay calling for help.

Delay in getting to a hospital for these life-or-death emergencies claims an enormous toll each year. About half of the 500,000 heart attack deaths expected in 2005, for instance, will occur before the victim reaches a hospital.

Studies show that the people with heart attack or stroke symptoms delay getting help for hours. The delay for heart attack symptoms averages 2.5 hours in some studies and 7 hours in others. People with stroke symptoms wait an average of three to four hours.

Getting to the hospital within the first hour or so can save a life. It also can prevent or reduce permanent damage to the heart or brain. Clot-busting drugs or emergency surgery can restore flow of blood to the heart or brain. They can actually stop a heart attack or stroke. But they work only if used soon after the heart attack or stroke begins.

Studies have found many reasons for delay, including failure to recognize the symptoms, which can differ from person to person.

Stroke symptoms may include sudden numbness or weakness in the face, arm or leg (especially on one side of the body); sudden confusion, dizziness, loss of balance or coordination; a sudden severe headache; or trouble speaking, seeing or walking.

Heart attack symptoms may include uncomfortable pressure or pain in the chest, arm or below the breastbone that lasts more than a few minutes; discomfort spreading to the back, jaw, throat or arm; a sensation of fullness, indigestion, or choking; sweating, nausea, vomiting or dizziness; extreme weakness, anxiety or shortness of breath; and rapid or irregular heartbeats.

The "811" system would involve a lower level of emergency response. The details are hazy, but the response would encourage people not sure about their symptoms to call for immediate help without worrying about creating a scene.



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