Document Detail


From theory to practice: implementation of pre-hospital electrocardiogram transmission in ST-elevation myocardial infarction - a multicenter experience.
MedLine Citation:
PMID:  21041847     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
BACKGROUND: Percutaneous coronary intervention for ST-elevation myocardial infarction (STEMI) reduces morbidity and mortality if performed rapidly. We examined whether timely intervention in myocardial perfusion times achieved at NorthEast Medical Center (NEMC) using pre-hospital (PH) electrocardiography (ECG) could be maintained during a 3-year follow-up period, and whether a similar system could be implemented at 6 other larger hospitals in a prospective, multicenter study.
METHODS: We calculated median door-to-reperfusion times for emergency medical services (EMS) and self-transport patients. PH wireless ECG transmission was attempted by trained EMS personnel with transmission to an on-call cardiologist's hand-held device. A standardized "STEMI code system" was implemented to further improve door-to-reperfusion times.
RESULTS: At NEMC, door-to-reperfusion times were similar in both the pilot study and follow-up periods, with a median time of 63 minutes. However, successful PH-ECG transmission was less frequent during the followup period (20% vs. 56%; p < 0.0001). At the 6 larger sites, both EMS and self-transport patients had lower door-to-reperfusion times in the study period compared to the pre-study period. However, successful PH-ECG transmission was rare in the EMS-transported patients (2%).
CONCLUSION: Initial reduction of reperfusion time at NEMC using PH-ECG transmission to the cardiologist was maintained over time, however, there was a decrease in the PH-ECG transmission rate. PHECG transmission was difficult to achieve in larger-sized communities. Successful PH-ECG transmission to an on-call cardiologist, together with an effective STEMI code system, can markedly reduce door-to-reperfusion times.
Authors:
George Adams; Ghassan Abusaid; Benjamin Lee; Charles Maynard; Paul Campbell; Galen Wagner; Alejandro Barbagelata
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of invasive cardiology     Volume:  22     ISSN:  1557-2501     ISO Abbreviation:  J Invasive Cardiol     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-11-02     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8917477     Medline TA:  J Invasive Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  520-5     Citation Subset:  IM    
Affiliation:
Duke Clinical Research Institute, Cardiology Division-Internal Medicine, 2400 Pratt Street, Room 0306 Terrace Level, Durham, NC 27705, USA.
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Comment In:
J Invasive Cardiol. 2010 Nov;22(11):526   [PMID:  21041848 ]

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