Twelve-Lead Electrocardiogram Acquisition With a Patchy-Type Wireless Device in Ambulance Transport: Simulation-Based Randomized Controlled Trial (Preprint)

Abstract

BACKGROUND Cardiovascular disease is the leading cause of death worldwide. Early recognition, early diagnosis, and early reperfusion are the key elements of treatment for ST-segment elevation myocardial infarction. Absence of prehospital 12-lead electrocardiogram (P12ECG) can cause definitive treatment delay and repeated transfer. Although guidelines highly recommend the measuring and transmitting of P12ECG data, P12ECG use has not been widely established. OBJECTIVE The aim of this study was to verify the time-efficiency and feasibility of using a patchy-type 12-lead ECG measuring and transmitting device by an emergency medical technician (EMT) in the ambulance during patient transport. METHODS This was a prospective randomized crossover controlled study that was simulation-based and included 119 emergency medical technicians. Participants were randomly assigned to one of two groups. Group A first underwent experiments with a conventional device and then transferred to an intervention device, and group B first underwent experiments with an intervention device and then transferred to a conventional device. All tests were conducted inside an ambulance driving at 30 km/h. The time interval was measured from the beginning of the ECG test application to the completion of sending the results. After the simulation test, participants were administered the System Usability Scale. RESULTS A total of 18 emergency medical technicians were recruited in this study, and the median age was 35 years old. The overall interval time for the conventional device was 254 s (interquartile range 247-270), whereas the overall interval time for the intervention device was 130 s (interquartile range 112-150) for significant differences (P<.001). Significant differences between the conventional device and intervention device were identified in all time intervals, and for all intervals except interval 1, the intervention device was found to be significantly faster. In interval 1, the conventional device was found to be faster than the intervention device (P=.034). CONCLUSIONS The capture and transmission of P12ECG data using patch-type ECG recorders in the transporting ambulance is faster compared with the use of a conventional defibrillator device. This study is registered at ClinicalTrials.gov (NCT04114760). CLINICALTRIAL This study was approved by the Samsung Medical Center Institutional Review Board (No. 2019-04-004) and registered at ClinicalTrials.gov (NCT04114760).