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September 28, 2011

Ambulance Diversion and Survival Among Patients With Acute Myocardial Infarction

Author Affiliations

Letters Section Editor: Jody W. Zylke, MD, Senior Editor.

Author Affiliations: Department of Emergency Medicine, University of Pennsylvania, Philadelphia (Dr Soremekun) (; Department of Emergency Medicine, Massachusetts General Hospital, Boston (Dr Brown); and Department of Emergency Medicine, George Washington University, Washington, DC (Dr Pines).

JAMA. 2011;306(12):1324-1325. doi:10.1001/jama.2011.1352

To the Editor: Emergency department (ED) crowding affects patients' access to care and is increasingly recognized as an important public health issue. To help mitigate crowding, many municipalities allow the diversion of ambulances to other hospitals when an ED becomes too crowded. In the recent study by Drs Shen and Hsia, patients with acute myocardial infarction (AMI) experienced higher mortality on days when the nearest hospital was on diversion for greater than 12 hours compared with when it was not on diversion.1 The premise is that because AMI is a time-sensitive condition, delays secondary to ambulance diversion are harmful.