Cellular telephone transmission of 12-lead electrocardiograms from ambulance to hospital

Grim, Pamela; Feldman, Ted; Martin, Michael; Donovan, Robert; Nevins, Vicki; Childers, Rory

doi:10.1016/0002-9149(87)90388-2

Cited by 112 publications

(29 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The diagnostic modality of choice has been the ECG. Prehospital ECG diagnosis was pioneered in the late 1980s, and advances in cellular phone technology made transmission of full 12 lead ECG's possible [13][14][15]. Hence, ECG interpretation was possible at a distance as the cardiologist on call could assist the paramedics and the ambulance physicians.…”

Section: Prehospital Ecg Diagnosis Of Patients With St Elevation Myocmentioning

confidence: 99%

Prehospital diagnosis of patients with acute myocardial infarction

et al. 2016

View full text Add to dashboard Cite

Primary percutaneous intervention (PPCI) is the preferred treatment in patients with ST elevation myocardial infarction (STEMI) if this can be performed in a timely manner. The 2012 ESC Guidelines on management of AMI in patients presenting with ST-segment elevation advice that PPCI should be performed within 120 min of first medical contact. Prehospital diagnosis of patients with STEMI is performed to save time and make PPCI available to the majority of patients. Although diagnosing patients with STEMI is usually easy, there are important pitfalls and patients with STEMI are missed on occasion. In addition, it is well know that patients without ST elevation may also have a high-risk cardiac condition. The 2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation stress the importance of urgent CAG in patients with high-risk non ST-segment elevation myocardial infarction (NSTEMI). Unfortunately, these patients are difficult to diagnose in the acute phase and important time may be spend establishing the correct diagnosis. Prehospital biomarker measurement has emerged as a method to gain important additional information. We review the evidence on prehospital diagnosis of patients with STEMI and, In addition, we present the current knowledge on the new diagnostic methods that could have a future role in prehospital rule-in and rule-out of cardiac disease.

show abstract

Section: Prehospital Ecg Diagnosis Of Patients With St Elevation Myocmentioning

confidence: 99%

Prehospital diagnosis of patients with acute myocardial infarction

et al. 2016

View full text Add to dashboard Cite

show abstract

“…Pre-hospital 12-lead electrocardiography entails application of recording electrodes, capture of electrocardiographic data, automated interpretation using diagnostic algorithms within the device, transmission capability, and the option for over-read of the output by paramedics. The quality of P12ECG data has been shown to be equal to that obtained in the hospital (35,36). Pre-hospital 12-lead electrocardiographic data are readily obtained at the point of care of the patient in the pre-hospital environment, without undue delay in transportation to the hospital (35,(37)(38)(39).…”

mentioning

confidence: 90%

Pre-Hospital 12-Lead Electrocardiography Programs

Garvey

MacLeod

Sopko

et al. 2006

Journal of the American College of Cardiology

View full text Add to dashboard Cite

Emergency medical services (EMS) providers who administer advanced life support should include diagnostic 12-lead electrocardiography programs as one of their services. Evidence demonstrates that this technology can be readily used by EMS providers to identify patients with ST-segment elevation myocardial infarction (STEMI) before a patient's arrival at a hospital emergency department. Earlier identification of STEMI patients leads to faster artery-opening treatment with fibrinolytic agents, either in the pre-hospital setting or at the hospital. Alternatively, a reperfusion strategy using percutaneous coronary intervention can be facilitated by use of pre-hospital 12-lead electrocardiography (P12ECG). Analysis of the cost of providing this service to the community must include consideration of the demonstrated benefits of more rapid treatment of patients with STEMI and the resulting time savings advantage shown to accompany the use of P12ECG programs.

show abstract

“…3,4 Paramedics can achieve a high success rate (98.7%) in obtaining diagnostic quality pre-hospital 12-lead ECGs in the majority of patients, 5 and 12-lead ECGs can be transmitted from a moving ambulance using cellular telephones. 6 However,. transmission of an ECG requires additional costly technology, immediate availability of a physician to confirm the diagnosis, and a fault-free line.…”

Section: Introductionmentioning

confidence: 99%

Diagnostic performance and potential clinical impact of advanced care paramedic interpretation of ST-segment elevation myocardial infarction in the field

May

Dionne

Maloney

et al. 2006

CJEM

View full text Add to dashboard Cite

Objectives: Most studies of pre-hospital management of ST-elevation myocardial infarction (STEMI) have involved physicians accompanying the ambulance crew, or electrocardiogram (ECG) transmission to a physician at the base hospital. We sought to determine if Advanced Care Paramedics (ACPs) could accurately identify STEMI on the pre-hospital ECG and contribute to strategies that shorten time to reperfusion. Methods: A STEMI tool was developed to: 1) measure the accuracy of the ACPs at diagnosing STEMI; and 2) determine the potential time saved if ACPs were to independently administer thrombolytic therapy. Using registry data, we subsequently estimated the time saved by initiating thrombolytic therapy in the field compared with in-hospital administration by a physician. Results: Between August 2003 and July 2004, a correct diagnosis of STEMI on the pre-hospital ECG was confirmed in 63 patients. The performance of the ACPs in identifying STEMI on the ECG resulted in a sensitivity of 95% (95% confidence interval [CI] 86%-99%), a specificity of 96% (95% CI 94%-98%), a positive predictive value (PPV) of 82% (95% CI 71%-90%), and a negative predictive value (NPV) of 99% (95% CI 97%-100%). ACP performance for appropriately using thrombolytic therapy resulted in a sensitivity of 92% (95% CI 78%-98%), a specificity of 97% (95% CI 94%-98%), a PPV of 73% (95% CI 59%-85%) and an NPV of 99% (95% CI 97%-100%). We estimated that the median time saved by ACP administration of thrombolytic therapy would have been 44 minutes. Conclusions: ACPs can be trained to accurately interpret the pre-hospital ECG for the diagnosis of STEMI. These results are important for the design of regional integrated programs aimed at reducing delays to reperfusion. RÉSUMÉ Objectifs : La plupart des études sur la prise en charge préhospitalière des infarctus du myocarde avec élévation du segment S-T (IMEST) ont été faites dans un contexte où les médecins accompag- ORIGINAL RESEARCH • RECHERCHE ORIGINALE ADVANCES

show abstract

Cellular telephone transmission of 12-lead electrocardiograms from ambulance to hospital

Cited by 112 publications

References 15 publications

Prehospital diagnosis of patients with acute myocardial infarction

Prehospital diagnosis of patients with acute myocardial infarction

Pre-Hospital 12-Lead Electrocardiography Programs

Diagnostic performance and potential clinical impact of advanced care paramedic interpretation of ST-segment elevation myocardial infarction in the field

Contact Info

Product

Resources

About