Prehospital 12-lead electrocardiogram for patients with chest pain: a pilot study

Prehospital 12-lead electrocardiogram for patients with chest pain: a pilot study

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). Fifteen ambulances equipped with X Series Monitor/Defibrill...

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Bibliographic Details
Published in:Hong Kong medical journal = Xianggang yi xue za zhi Vol. 24; no. 5; pp. 484 - 491
Main Authors: Cheung, K S, Leung, L P, Siu, Y C, Tsang, T C, Tsui, M Sh, Tam, C C, Chan, R Hw
Format: Journal Article
Language:English
Published: China Hong Kong Academy of Medicine 01-10-2018
Subjects:
Aged
Chest Pain - etiology
Consent
Decision Trees
Electrocardiography
Electrocardiography - instrumentation
Emergency medical care
Emergency Medical Services - standards
Female
Hong Kong
Humans
Male
Mortality
Myocardial Infarction - complications
Myocardial Infarction - diagnosis
Myocardial Infarction - physiopathology
Outcome Assessment (Health Care)
Pain
Patients
Physicians
Pilot Projects
Retrospective Studies
Hong Kong
Hong Kong China
United States > US
China
Electrocardiography
Percutaneous coronary intervention
Ambulances
ST elevation myocardial infarction
Chest pain
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Summary: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). 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. 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 ECG (112 minutes) and that for 41 patients with STEMI with self-arranged transport (138 minutes). However, shorter reperfusion time was only recorded during daytime hours (08:00-17:59). No statistically significant difference in 30-day mortality was found. Prehospital ECG is technologically feasible in Hong Kong and shortens the D2B time. However, shorter reperfusion time was only recorded during daytime hours.
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ISSN:1024-2708
2226-8707
DOI:10.12809/hkmj177135