Hostname: page-component-cd9895bd7-gxg78 Total loading time: 0 Render date: 2024-12-27T05:07:17.214Z Has data issue: false hasContentIssue false
  • English
  • Français

12-Lead Electrocardiograms Acquired and Transmitted by Emergency Medical Technicians are of Diagnostic Quality and Positively Impact Patient Care

Published online by Cambridge University Press:  29 October 2020

Vladimir Kotelnik ,
Kevin Pesce ,
William M. Masterton ,
Robert T. Marshall ,
Gregson Pigott ,
Nathaniel Bialek ,
Jason Winslow  and
Lauren M. Maloney Open the ORCID record for Lauren M. Maloney [Opens in a new window]
Vladimir Kotelnik
Affiliation:
Department of Emergency Medicine, Stony Brook University Hospital, Stony Brook, New YorkUSA
Kevin Pesce
Affiliation:
Department of Emergency Medicine, Stony Brook University Hospital, Stony Brook, New YorkUSA
William M. Masterton
Affiliation:
Suffolk County Department of Health Services, Yaphank, New YorkUSA
Robert T. Marshall
Affiliation:
Department of Emergency Medicine, Stony Brook University Hospital, Stony Brook, New YorkUSA
Gregson Pigott
Affiliation:
Suffolk County Department of Health Services, Yaphank, New YorkUSA
Nathaniel Bialek
Affiliation:
Suffolk County Department of Health Services, Yaphank, New YorkUSA
Jason Winslow
Affiliation:
Suffolk County Department of Health Services, Yaphank, New YorkUSA
Lauren M. Maloney*
Affiliation:
Department of Emergency Medicine, Stony Brook University Hospital, Stony Brook, New YorkUSA
*
Correspondence: Lauren M. Maloney, MD, NRP, FP-C, NCEE Stony Brook University Hospital Department of Emergency Medicine HSC Level 4 Room 050 Stony Brook, New York11794-8350USA E-mail: lauren.maloney@stonybrookmedicine.edu
Get access Rights & Permissions [Opens in a new window]

Abstract

Introduction:

Existing peer-reviewed literature describing emergency medical technician (EMT) acquisition and transmission of 12-lead electrocardiograms (12L-ECGs), in the absence of a paramedic, is largely limited to feasibility studies.

Study Objective:

The objective of this retrospective observational study was to describe the impact of EMT-acquired 12L-ECGs in Suffolk County, New York (USA), both in terms of the diagnostic quality of the transmitted 12L-ECGs and the number of prehospital percutaneous coronary intervention (PCI)-center notifications made as a result of transmitted 12L-ECGs demonstrating a ST-elevation myocardial infarction (STEMI).

Methods:

A pre-existing database was queried for Emergency Medical Services (EMS) calls on which an EMT acquired a 12L-ECG from program initiation (January 2017) through December 31, 2019. Scanned copies of the 12L-ECGs were requested in order to be reviewed by a blinded emergency physician.

Results:

Of the 665 calls, 99 had no 12L-ECG available within the database. For 543 (96%) of the available 12L-ECGs, the quality was sufficient to diagnose the presence or absence of a STEMI. Eighteen notifications were made to PCI-centers about a concern for STEMI. The median time spent on scene and transporting to the hospital were 18 and 11 minutes, respectively. The median time from PCI-center notification to EMS arrival at the emergency department (ED) was seven minutes (IQR 5-14).

Conclusion:

In the event a cardiac monitor is available, after a limited educational intervention, EMTs are capable of acquiring a diagnostically useful 12L-ECG and transmitting it to a remote medical control physician for interpretation. This allows for prehospital PCI-center activation for a concern of a 12L-ECG with a STEMI, in the event that a paramedic is not available to care for the patient.

Keywords

12-lead electrocardiogramEmergency Medical Servicesemergency medical technicianprehospitalSTEMI
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 36 , Issue 1 , February 2021 , pp. 47 - 50
Check for updates
Copyright
© The Author(s), 2020. Published by Cambridge University Press on behalf of the World Association for Disaster and Emergency Medicine

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Rathore, SS, Curtis, JP, Chen, J, et al. Association of door-to-balloon time and mortality in patients admitted to hospital with ST elevation myocardial infarction: national cohort study. BMJ. 2009;338:b1807.CrossRefGoogle ScholarPubMed
O’Gara, PT, Kushner, FG, Ascheim, DD, et al. 2013 ACCF/AHA Guideline for the Management of ST-Elevation Myocardial Infarction. A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. 2013;61(4):e78-e140.Google ScholarPubMed
National Highway Traffic Safety Administration. National EMS Education Standards. https://www.ems.gov/pdf/National-EMS-Education-Standards-FINAL-Jan-2009.pdf. Accessed June 2020.Google Scholar
National Highway Traffic Safety Administration. National EMS Scope of Practice Model. https://www.ems.gov/pdf/education/EMS-Education-for-the-Future-A-SystemsApproach/National_EMS_Scope_Practice_Model.pdf. Accessed June 2020.Google Scholar
National Association of State EMS Officials. National EMS Scope of Practice Model 2019 (Report No. DOT HS 812-666). Washington, DC USA: National Highway Traffic Safety Administration; 2019.Google Scholar
Provo, TA, Frascone, RJ. 12-lead electrocardiograms during basic life support care. Prehosp Emerg Care. 2004;8(2):212-216.Google ScholarPubMed
Werman, HA, Newland, R, Cotton, B. Transmission of 12-lead electrocardiographic tracings by Emergency Medical Technician-Basics and Emergency Medical Technician-Intermediates: a feasibility study. Am J Emerg Med. 2011;29(4):437-440.CrossRefGoogle ScholarPubMed
Froats, M, Reed, A, Dionne, R, et al. The safety of bypass to percutaneous coronary intervention facility by Basic Life Support providers in patients with ST-elevation myocardial infarction in prehospital setting. J Emerg Med. 2018;55(6):792-798.CrossRefGoogle ScholarPubMed
Litell, JM, Meyers, HP, Smith, SW. Emergency physicians should be shown all triage ECGs, even those with a computer interpretation of “Normal.” J Electrocardiol. 2019;54:79-81.CrossRefGoogle ScholarPubMed