Paramedics as decision makers on the activation of the catheterization laboratory in the presence of acute ST-elevation myocardial infarction.
Journal of Electrocardiology · 2010-09-14 · Observational study
Abstract
MATERIALS AND METHODS: To minimize delays in time to reperfusion in an urban-suburban North Carolina County, Guilford County Emergency Medical Services (EMS) and Moses Cone Hospital, Greensboro, NC, have collaborated to use the acquisition of 12-lead electrocardiographs and their paramedic interpretation to initiate the catheterization laboratory team and cardiologist; independent of over read by a physician. The study population of 91 patients was divided into the catheterization laboratory activation by EMS and catheterization laboratory activation by the emergency department physician (ED-MD) groups, and also by EMS and self-transported groups. RESULTS: The EMS group had shorter median time intervals from hospital door to percutaneous coronary intervention (PCI) with balloon inflation than those patients who self-transported to the hospital. Also, patients who were treated during the EMS activation of the catheterization laboratory phase had shorter median hospital door to PCI times than those who were treated during ED-MD activation of the catheterization laboratory. CONCLUSION: The time from hospital arrival to PCI with balloon inflation was significantly shorter during the period in which EMS activated the catheterization laboratory than during the period the laboratory was activated by hospital staff. Thus, paramedics with quality electrocardiogram interpretation training and education can identify patients with acute ST-elevation myocardial infarction and properly activate the catheterization laboratory.
Abstract © the authors or publisher, via PubMed. Reuse and removal
Tags
Time intervals · Triage instruments · Urban · ECG transmission · Paramedics & EMTs
Related articles
- Cardiac Outcomes Through Digital Evaluation (CODE) STEMI project: prehospital digitally-assisted reperfusion strategies. (Can J Cardiol, 2012)
- Rates of cardiac catheterization cancelation for ST-segment elevation myocardial infarction after activation by emergency medical services or emergency physicians: results from the North Carolina Catheterization Laboratory Activation Registry. (Circulation, 2012)
- A citywide protocol for primary PCI in ST-segment elevation myocardial infarction. (N Engl J Med, 2008)
- Effectiveness of a Prehospital Wireless 12-Lead Electrocardiogram and Cardiac Catheterization Laboratory Activation for ST-Elevation Myocardial Infarction. (Am J Cardiol, 2017)
- An algorithm for identification of ST-elevation myocardial infarction patients by emergency medicine services. (Am J Emerg Med, 2013)
- The ECG as decision support in STEMI. (Dan Med J, 2012)