12-Lead Electrocardiograms Acquired and Transmitted by Emergency Medical Technicians are of Diagnostic Quality and Positively Impact Patient Care. Issue 1 (29th October 2020)

• Record Type: Journal Article
• Authors: Kotelnik, Vladimir; Pesce, Kevin; Masterton, William M.; Marshall, Robert T.; Pigott, Gregson; Bialek, Nathaniel; Winslow, Jason; Maloney, Lauren M.
• Is Part Of: Prehospital and disaster medicine. Volume 36:Issue 1(2021)
• Page Start: 47
• Page End: 50
• Publication Date: 2020-10-29
• Subjects: 12-lead electrocardiogram, -- Emergency Medical Services, -- emergency medical technician, -- prehospital, -- STEMI; Emergency medical services -- Periodicals; Emergency medicine -- Periodicals; Disaster medicine -- Periodicals; 616.025
• DOI: 10.1017/S1049023X20001259
• Languages: English
• ISSNs: 1049-023X

Abstract

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.