Cardiac Outcomes Through Digital Evaluation (CODE) STEMI Project: Prehospital Digitally-Assisted Reperfusion Strategies

Ducas, Robin; Philipp, R; Jassal, Davinder S.; Wassef, Anthony; Weldon, Erin; Hussain, Farrukh; Schmidt, Christian; Khadem, Aliasghar; Ducas, John; Grierson, Rob; Tam, James W.

doi:10.1016/j.cjca.2012.02.005

Cited by 26 publications

(13 citation statements)

References 20 publications

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“…Two crucial aspects of this phase are the rapid diagnosis of STEMI and time from diagnosis to transport to a PCI facility . Time to reperfusion therapy is shortened when a pre‐hospital electrocardiogram (ECG) is obtained, allowing for the rapid diagnosis of STEMI, which should (in most cases) lead to bypassing a non‐PCI hospital in favor of direct transport to a PCI‐capable facility . Little is known about the impact of a pre‐hospital ECG on time to treatment in rural settings or on clinical outcomes.…”

Section: Introductionsupporting

confidence: 70%

Impact of pre‐hospital electrocardiograms on time to treatment and one year outcome in a rural regional ST‐segment elevation myocardial infarction network

Kahlon

Barn

Akram

et al. 2016

Cathet Cardio Intervent

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Section: Introductionsupporting

confidence: 70%

Impact of pre‐hospital electrocardiograms on time to treatment and one year outcome in a rural regional ST‐segment elevation myocardial infarction network

Kahlon

Barn

Akram

et al. 2016

Cathet Cardio Intervent

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“…Table 1 summarizes the primary data table, including the condition type, geographic region, and method for telehealth delivery. 8–75…”

Section: Resultsmentioning

confidence: 99%

A systematic review of prehospital telehealth utilization

et al. 2017

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Objective There has been moderate evidence of telehealth utilization in the field of emergency medicine, but less is known about telehealth in prehospital emergency medical services (EMS). The objective of this study is to explore the extent, focus, and utilization of telehealth for prehospital emergency care through the analysis of published research. Methods The authors conducted a systematic literature review by extracting data from multiple research databases (including MEDLINE/PubMed, CINAHL Complete, and Google Scholar) published since 2000. We used consistent key search terms to identify clinical interventions and feasibility studies involving telehealth and EMS, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results We identified 68 articles focused specifically on telehealth interventions in prehospital care. The majority (54%) of the studies involved stroke and acute cardiovascular care, while only 7% of these (4) focused on telehealth for primary care. The two most common delivery methods were real-time video-conferencing capabilities (38%) and store and forward (25%); and this variation was based upon the clinical focus. There has been a significant and positive trend towards greater telehealth utilization. European telehealth programs were most common (51% of the studies), while 38% were from the United States. Discussion and Conclusions Despite positive trends, telehealth utilization in prehospital emergency care is fairly limited given the sheer number of EMS agencies worldwide. The results of this study suggest there are significant opportunities for wider diffusion in prehospital care. Future work should examine barriers and incentives for telehealth adoption in EMS.

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“…Many regions and STEMI care networks in Canada have shown improvements in reperfusion times and clinical outcomes in STEMI patients who have been treated through the development of organized regional STEMI programs that emphasize prehospital electrocardiogram (ECG) diagnosis, EMS bypass of nonePCI-capable hospitals, and geographic and resource-based decision-making regarding the choice of an upfront reperfusion strategy. [22][23][24][25][26] The Ottawa program showed that EMS diagnosis of STEMI in the field with direct transfer to a PPCI centre was associated with a reduction in in-hospital mortality compared with treatment at the nearest hospital. 17 It has been suggested that prehospital STEMI diagnosis in conjunction with prehospital fibrinolysis could also be similarly driven by EMS.…”

Section: Methodsmentioning

confidence: 99%

2019 Canadian Cardiovascular Society/Canadian Association of Interventional Cardiology Guidelines on the Acute Management of ST-Elevation Myocardial Infarction: Focused Update on Regionalization and Reperfusion

Wong

Welsford

Ainsworth

et al. 2019

Canadian Journal of Cardiology

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125

111

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Rapid reperfusion of the infarct-related artery is the cornerstone of therapy for the management of acute ST-elevation myocardial infarction (STEMI). Canada's geography presents unique challenges for timely delivery of reperfusion therapy for STEMI patients. The Canadian R ESUM ELa reperfusion rapide de l'artère responsable de l'infarctus est la pierre angulaire th erapeutique de la prise en charge de l'infarctus aigu du myocarde avec el evation du segment ST (STEMI). Les caract eristiques g eographiques du Canada posent des d efis particuliers pour prodiguer aux

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Cardiac Outcomes Through Digital Evaluation (CODE) STEMI Project: Prehospital Digitally-Assisted Reperfusion Strategies

Cited by 26 publications

References 20 publications

Impact of pre‐hospital electrocardiograms on time to treatment and one year outcome in a rural regional ST‐segment elevation myocardial infarction network

Impact of pre‐hospital electrocardiograms on time to treatment and one year outcome in a rural regional ST‐segment elevation myocardial infarction network

A systematic review of prehospital telehealth utilization

2019 Canadian Cardiovascular Society/Canadian Association of Interventional Cardiology Guidelines on the Acute Management of ST-Elevation Myocardial Infarction: Focused Update on Regionalization and Reperfusion

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