Does your service perform prehospital 12 lead ECGs?
Does the prehospital 12 lead ECG help determine your transport destination?
Is the cath lab activated based on the prehospital 12 lead ECG?
Does your program rely on the paramedic interpretation of the 12 lead ECG? Does your program rely on computerized interpretation of the 12 lead ECG? Does your program rely on off-site interpretation of the 12 lead ECG by a physician? Does your program utilize a combination of these three methods?
If the prehospital 12 lead ECG is transmitted for off-site interpretation by a physician, what technology are you using? What is the failure rate? How is the data quality?
What was your initial education in 12 lead ECG interpretation?
Did it include a strong emphasis on STE-mimics (left bundle branch block, paced rhythm, left ventricular hypertrophy, benign early repolarization, pericarditis, hyperkalemia, etc.)?
Is there anything notable about your QA/QI process (regular multidisciplinary meetings at the hospital, data sharing, every 12 lead ECG reviewed by the Medical Control Physician, paramedics taken out of service and allowed to watch the cath procedure, etc.)?
Is your state involved in regionalizing STEMI care (similiar to trauma)?
How often are you called to the local community hospital for interhospital transfer of STEMI patients for primary PCI?
What has been the biggest barrier to the success of your prehospital 12 lead ECG program?