Cellular technology improves transmission success of pre-hospital electrocardiograms - 26/10/13

Doi : 10.1016/j.ajem.2013.07.032

Nicholas Larochelle, MD ^a,^{^{1
Formerly with University of Vermont College of Medicine, Burlington, VT.}}, Michael O’Keefe, MS, EMT-P ^b, Daniel Wolfson, MD ^b,^c,^{^{2
Formerly Vermont EMS District 3, Burlington, VT.}}, Kalev Freeman, MD, PhD ^b,^{^⁎}
^a University of Pittsburgh Emergency Medicine Residency, Pittsburgh, PA, USA
^b University of Vermont Department of Surgery, Burlington, VT, USA
^c Vermont Department of Health Emergency Medical Services, Burlington, VT, USA

^⁎Corresponding author. University of Vermont Dept of Surgery, 89 Beaumont Ave, Burlington VT 05405, USA. Tel.: +1 802 656 4216; fax: +1 802 656 0860.

Abstract

Study objective

In rural settings, long distances and transport times pose a challenge for achieving early reperfusion goals in patients with ST-elevation myocardial infarction (STEMI). This study investigated the association between the method of pre-hospital 12-lead ECG transmission (radio transmission vs. cellular phone transmission) and the success of transmission and legibility of 12-lead ECGs in a rural setting.

Methods

Observational study of pre-hospital 12-lead ECG transmission to the emergency department (ED) in a predominantly rural area. Success of transmission and the legibility of the 12-lead ECG were analyzed to identify barriers to 12-lead ECG transmission and reasons for failed transmission.

Results

Emergency medical services performed ECGs on 1140 patients, 917 of which they attempted to transmit, including 43 cases requiring emergent catheterization. Twelve-lead ECG transmission was successful in 236 (70%) of 337 radio attempts and 441 (76%) of 580 cellular attempts (difference 6.0%, 95% CI 1.1-12.1). Legibility increased from 164 (49%) of 337 radio attempts to 389 (67%) of 580 cellular attempts (difference 18.4%, 95% CI 11.8–24.9).

Conclusion

The success of transmission and legibility of 12-lead ECGs was significantly higher with cellular technology by emergency medical service agencies in comparison to radio transmission. In rural settings with lengthy transport times, utilization of cellular technology for transmission of pre-hospital 12-lead ECGs may improve door-to-balloon times for STEMI patients.

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Methods and measurements

Characteristics of study subjects

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Discussion

☆	Support: This research received no support in the form of equipment, drugs, or grants.

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Vol 31 - N° 11

P. 1564-1570 - novembre 2013 Retour au numéro

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Cellular technology improves transmission success of pre-hospital electrocardiograms - 26/10/13

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