Following symptom onset, 45% of patients initially decided to call the EMS rather than other sources of help such as their physician, family/friends, or to refer themselves directly to hospital. As predicted, patients who contacted the EMS for help were more likely to have short total pre-hospital delays: 74.0% of patients who contacted the EMS had total pre-hospital delays ≤ 120 min compared with 33.0% of those who contacted another source of help (adjusted OR 5.80, C.I. 2.98 to 11.30). Patients who contacted the EMS also had shorter decision times; 80.3% had a decision time ≤ 60 min compared with 45.7% who contacted another source of help (adjusted OR 4.83, C.I. 2.40 to 9.70). Interestingly, contacting the EMS was not related to the home-to-hospital component of the total pre-hospital delay period but only to decision time.