Recognition of ST elevation by paramedics. Issue 1 (1st January 2002)

• Record Type: Journal Article
• Authors: Whitbread, M; Leah, V; Bell, T; Coats, T J
• Is Part Of: Emergency medicine journal. Volume 19:Issue 1(2002)
• Page Start: 66
• Page End: 67
• Publication Date: 2002-01-01
• Subjects: electrocardiography -- myocardial infarction -- emergency medical technicians; AMI, acute myocardial infarction -- ECG, electrocardiogram -- PPV, positive predictive value -- NPV, negative predictive value; Emergency medicine -- Periodicals; 616.02505
• DOI: 10.1136/emj.19.1.66
• Languages: English
• ISSNs: 1472-0205

Abstract

Abstract : Objective: To define the ability of UK paramedics to recognise ST segment elevation using a prehospital 12 lead electrocardiogram (ECG). Methods: Analysis of the diagnostic ability of seven paramedics 12 months after a two day training course, using interpretation of a 12 lead ECG by two cardiologists as the criterion standard. Comparison of paramedic and A&E SHO diagnosis to determine accuracy, specificity, sensitivity, negative predictive value, and positive predictive value of paramedic interpretation. Results: Paramedics showed a median accuracy of 0.95 (95% CI 0.88 to 0.98), a specificity of 0.91 (95% CI 0.53 to 1.0), a sensitivity of 0.97 (95% CI 0.94 to 0.99), a NPV of 0.77 (95% CI 0.62 to 0.92) and a PPV of 0.99 (95% CI 0.92 to 1.0). This was not significantly different from a group of experienced A&E SHOs. Conclusions: UK paramedics can recognise ST elevation using a 12 lead ECG. Radio transmission of an ECG may not be necessary to pre-alert the hospital.