ECG pre-hospital teletransmission by emergency teams staffed with an emergency physician and paramedics and its impact on transportation and hospital admission

Abstract

Electrocardiography (ECG) is essential to detect and diagnose life threatening cardiac conditions and to determine further treatment. Correct interpretation of an ECG can be challenging, especially in the out-of-hospital setting and by less experienced emergency team members. The aim of this study was to compare the rate of ECG transmission from an out-of-hospital emergency scene to an in-hospital cardiologist on call in EMS-B and EMS-S providers and its impact on direct transportation to a cardiac catheterization laboratory and hospital admission. The study was designed as an observational study. Data from 3 separate emergency medical service teams were collected. Two teams are staffed by paramedics only (EMT-B), while another specialized team is staffed with an emergency physician (EMT-S). 5864 out-of-hospital emergencies were performed during a 12-month period and were analyzed for this study. In 124 out of 5864 (2.1%) out-of-hospital emergencies, an ECG transmission from the out-of-hospital scene to an in-hospital cardiologist on call was performed. Rate of transmission was similar between both teams (EMT-B n = 70, 2.2% vs EMT-S n = 54, 2.0%, P = .054). After coordinating with the cardiologist on call, 11 patients (15.7%) of the EMT-B (15.7%) and 24 patients (44.4%) of the EMT-S were directly transported from the scene of emergency to a cardiac catheterization laboratory ( P < .001). Overall, 80% of patients treated by EMT-S, compared to 52.5% treated by the EMT-B required subsequent hospital admission ( P < .05). Transmission of ECG from the out-of-hospital emergency scene to the in-hospital cardiologist is infrequently performed. The rate of STEMI in transmitted ECG's by emergency teams staffed with an emergency physician was higher compared to emergency teams staffed with paramedics only.

The Recent Advances of Mobile Healthcare in Cardiology Practice

“…The application of mobile technologies for health practice led to the significant improvement of early diagnostic and timely treatment of life-threating conditions such as cardiac arrest ( 113 - 118 ). In fact, early cardiopulmonary resuscitation and defibrillation using digital technologies could help safe many lives.…”

Assessment of Electrocardiogram Interpretation Competency among Health Professional staff and Students of Ardabil University of Medical Sciences: A Multidisciplinary Study

“…ECG interpretation is often poor at the undergraduate and graduate levels [30]. Early detection and rapid revascularization of STEMI is essential and potentially life-saving [31]. The quick and correct diagnosis and interpretation of myocardial infarction can signi cantly reduce the door-to-balloon time for reperfusion [32].…”

“…This may be justi ed by the fact that the staff and students of nursing, anesthesiology and EMS do not have to interpret ECGs on a daily basis, unlike medical practitioners and students. Also, medical practitioners and students receive more personal training and expertise in ECG interpretation [2,31]. This is a warning sign for healthcare policymakers, who need to plan and implement useful measures to train paramedics in ECG interpretation and ensure they are specialized in this task.…”

Twelve-Lead Electrocardiogram Acquisition With a Patchy-Type Wireless Device in Ambulance Transport: Simulation-Based Randomized Controlled Trial (Preprint)

“…A study performed in Los Angeles found that among those diagnosed with ST-segment elevation myocardial infarction (STEMI) by P12ECG, only 28% had their data transmitted to the hospital; in 55% of cases, the data were not transmitted and for 17% of these cases the transmission status was not recorded [9]. In another study performed in Poland, 12-lead ECG was transmitted to the hospital by an emergency medical service (EMS) team for only 2% of patients [10].…”