Paramedics and pre-hospital management of acute myocardial infarction: diagnosis and reperfusion

Challenges and solutions in medically managed ACS in the Asia-Pacific region: Expert recommendations from the Asia-Pacific ACS Medical Management Working Group

“…Pre-hospital triage with ECG [61,62] performed by well-trained paramedics provides rapid diagnosis, permitting suspected STEMI patients to be transported directly to appropriate hospitals, minimizing treatment delay [63,64]. Despite recommendations for early triage and treatment initiation in current ACS guidelines, preliminary data from EPICOR Asia show that nearly two-thirds of patients presenting with ACS in Asia fail to receive any pre-hospital ECG [65].…”

The barriers associated with emergency medical service use for acute coronary syndrome: the awareness and influence of an Australian public mass media campaign

“…Transport by EMS also ensures suspected patients with ACS present to hospitals with revascularisation capabilities. In addition, some EMS are able to initiate intravenous reperfusion (ie, thrombolysis) to a subset of patients with ACS 7. However, across a number of international settings, a large proportion of patients with ACS are still transporting themselves to hospital (40%–50%) 8–10.…”

Impact of implementation of evidence-based strategies to reduce door-to-balloon time in patients presenting with STEMI: continuous data analysis and feedback using a statistical process control plot

“…This is only possible by continuous training of paramedics to interpret 12-lead ECGs and ongoing communication and feedback between the paramedics and the cardiology team. Some units do not depend on telemetry and this is possible when confidence grows in the ability of paramedics to interpret ECGs correctly 19. All CCU coordinators were well-trained senior nursing staff who had previous experience in nurse-led thrombolysis.…”