After ST-segment elevation myocardial infarction (STEMI), it is vital to shorten reperfusion time. This study examined data from a pilot project to shorten the door-to-balloon (D2B) time by using prehospital 12-lead electrocardiogram (ECG). Methods: Fifteen ambulances equipped with X Series ® Monitor/Defibrillator (Zoll Medical Corporation) were deployed to the catchment area of Queen Mary Hospital, Hong Kong, from November 2015 to December 2016. For patients with chest pain, prehospital 12-lead ECG was performed and tele-transmitted to attending physicians at the accident and emergency department for immediate interpretation. The on-call cardiologist was called before patient arrival if STEMI was suspected. Data from this group of patients with STEMI were compared with data from patients with STEMI who were transported by ambulances without prehospital ECG or by self-arranged transport. Results: From 841 patients with chest pain, 731 gave verbal consent and prehospital ECG was performed and transmitted. Of these, 25 patients with clinically diagnosed STEMI required emergency coronary angiogram with or without primary percutaneous coronary intervention. The mean D2B time for these 25 patients (93 minutes) was significantly shorter (P=0.003) than that for 58 patients with STEMI transported by ambulances without prehospital
Total ischaemic time should be shortened as much as possible in patients with STsegment elevation myocardial infarction (STEMI). This study evaluated whether prehospital 12-lead electrocardiogram (ECG) could shorten system delay in STEMI management.
Introduction: Tetrodotoxin poisoning is typically caused by puffer fish consumption. This study is to review its demographics, clinical presentations and management in Hong Kong. Method: Reported cases of tetrodotoxin poisoning to Hong Kong Poison Information Centre from October 2008 to March 2021 were included in the study. Information from electronic database was analysed. Results: Forty-two cases were included in this case series. The number of incidents of tetrodotoxin poisoning ranged from 0 to 5 per year, mostly in the winter months. Median ingestion-to-symptom and ingestion-to-door time was 2 and 6.5 h, respectively. 48% of puffer fish meal sharer was symptomatic and attended emergency department. 100% and 48% of all cases had neurological and cardiovascular/gastrointestinal symptoms, respectively. Fukuda and Tani clinical Grade 1 and 2 were the most common presentation. 17% required intensive care while most patients were managed safely in emergency department and/or emergency medicine ward. Conclusion: There are recurrent incidents of tetrodotoxin poisoning in Hong Kong. Public education is the key to prevent future outbreaks. Targeted history and enhanced availability of tetrodotoxin test would assist in its diagnoses.
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