Effectiveness of Prehospital Wireless Transmission of Electrocardiograms to a Cardiologist Via Hand-Held Device for Patients With Acute Myocardial Infarction (from the Timely Intervention in Myocardial Emergency, NorthEast Experience [TIME-NE])

Adams, George L.; Campbell, P.; Adams, John M.; Strauss, David G.; Wall, Karen; Patterson, Janet; Shuping, Kathy B.; Maynard, Charles; Young, Dwayne; Corey, Craig; Thompson, Alan; Lee, Benjamin A.; Wagner, Galen S.

doi:10.1016/j.amjcard.2006.05.042

Cited by 115 publications

(59 citation statements)

References 8 publications

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“…Components include prehospital ECGs and notification of the receiving facility, [45][46][47][48][49][50][51][52][53][54][55][56][57][58][59][60] and activation of the cardiac catherization team to shorten reperfusion time 54,59,82,89 -92 and other hospital personnel important for treatment and resource allocation.…”

Section: Systems Of Carementioning

confidence: 99%

Part 10: Acute Coronary Syndromes

O’Connor¹,

Brady²,

Brooks³

et al. 2010

Circulation

238

167

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Section: Systems Of Carementioning

confidence: 99%

Part 10: Acute Coronary Syndromes

O’Connor¹,

Brady²,

Brooks³

et al. 2010

Circulation

238

167

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“…655,660 When comparing the door-to-reperfusion time for patients with a prehospital ECG and prehospital activation to patients with no prehospital ECG, the mean door-to-reperfusion interval was reduced by more than 30 minutes. 660 Two nonrandomized trials reported no significant reductions in mortality with the use of prehospital ECGs (LOE 2).…”

Section: Consensus On Sciencementioning

confidence: 99%

“…Eight studies demonstrated a reduction in the reperfusion delay (with varied time interval definitions) ranging from 15 to 65 minutes in patients treated with PCI (LOE 2 [655][656][657][658] ; LOE 3 112,659,660 ; LOE 4 661 ).…”

Section: Consensus On Sciencementioning

confidence: 99%

Part 9: Acute Coronary Syndromes

Bossaert

O’Connor²,

Arntz³

et al. 2010

Circulation

103

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These experts reviewed 25 topics related to the acute initial management of acute coronary syndrome (ACS), which was further categorized as unstable angina, non-ST-elevation MI (UA/NSTEMI) and ST-elevation MI (STEMI). Topics were identified based on previous recommendations, emerging science, and clinical importance, using an iterative writing process involving all Task Force members. The Task Force reviewed the evidence specifically related to diagnosis and treatment of ACS in the out-ofhospital setting and the first hours of care in the in-hospital setting, typically in the emergency department (ED). The evidence review took place over several years, with ongoing refinement of recommendations being made as new evidence was published. The purpose of the review was to generate current, evidence-based treatment recommendations for healthcare providers who serve as the initial point of contact for patients with signs and symptoms suggestive of ACS.The following is a summary of the most important changes in recommendations for diagnosis and treatment of ACS since the last ILCOR review in 2005. 1,2• The history and physical examination, initial ECG, and initial serum biomarkers, even when used in combination, cannot be used to reliably exclude ACS in the prehospital and ED settings.• In contrast, chest pain observation protocols are useful in identifying patients with suspected ACS and patients who require admission or may be referred for provocative testing for coronary artery disease (CAD) to identify reversible ischemia. Such strategies also reduce cost by reducing unnecessary hospital admissions and improve patient safety through more accurate identification of NSTEMI and STEMI.• The acquisition of a prehospital 12-lead ECG is essential for identification of STEMI patients before hospital arrival and should be used in conjunction with pre-arrival hospital notification and concurrent activation of the catheter laboratory.• Nonphysicians can be trained to independently interpret 12-lead ECGs for the purpose of identifying patients with STEMI, provided that appropriate and reliable STEMI criteria are used. This skill is of particular value in the prehospital setting where paramedics may independently identify STEMI, thus mitigating over-reliance on ECG transmission.• Computer-assisted ECG interpretation can be used to increase diagnostic accuracy of STEMI diagnosis when used alone or in combination with ECG interpretation by a trained healthcare provider.• STEMI systems of care can be implemented to improve the time to treatment. The following measures have been shown to reduce the time to primary percutaneous coronary intervention (PPCI): institutional commitment, use of a team-based approach, arranging single-call activation of the catheterization laboratory by the emergency physician or prehospital provider, requiring the catheterization laboratory to be ready in 20 minutes, having an experienced cardiologist always available, and providing real-time data feedback.• Intravenous (IV) ␤-blockers should not be give...

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“…In the TIME-NE trial, transmission was successful in 24 patients and failed in 19 patients. 20 Väisänen et al reported that 18% of transmissions with advanced mobile phone failed. 22 In contrast, as with the MTS, 16 there were no transmission failures in the STAT-MI trial 19 or in the Takeuchi et al study.…”

Section: Prehospital Transfer Pathway Influences Time To Reperfusionmentioning

confidence: 99%