Prehospital ECG Speeds STEMI Care

MedPage Today is reporting something that should come as no surprise to anyone who’s been paying attention.

Photo credit: MedPage Today

It’s a review of Rao A, et al “Impact of the prehospital ECG on door-to-balloon time in ST-elevation myocardial infarction” Catheter Cardiovasc Interv 2010; 75: 174-78.

They write:

“Transmitting ECG results from the field to the emergency department dramatically improved door-to-balloon time for patients with ST-elevation myocardial infarction (STEMI), researchers found.

“The strategy cut a half hour from the process, from 90.5 minutes to 60.2 minutes (P<0.0001), well within the recommended 90-minute window, according to Shukri David, MD, of Providence Hospital and Medical Center in Southfield, Mich., and colleagues.

“Nearly all patients who had a prehospital ECG (97.4%) had a door-to-balloon time of less than 90 minutes, compared with only 61.5% of those who had an ECG upon arrival at the hospital (P<0.001), the researchers reported in the January issue of Catheterization and Cardiovascular Interventions."

The article also highlights what is, in my opinion, the most important (and obvious) advantage of the prehospital 12-lead ECG.

“The use of the prehospital ECG is a way of overcoming the obstacle of delay in cardiac catheterization laboratory activation during off-hours,” the researchers wrote.”

The concept is “parallel processing”.

PCI-hospitals can and should be calling in the cath team while the paramedics are still in the field, especially on nights, weekends, and holidays when the cardiac cath lab is not staffed 24 hours a day.

Why would anyone fail to take advantage of that?

Time is therapy for STEMI patients! It can’t be repeated often enough.

The time is rapidly approaching where failure to activate the cardiac cath lab based on the prehospital 12-lead ECG will be viewed as negligence.

See additional news coverage:

Prehospital ECG speeds STEMI patients’ route to cath lab

Heart attack victims who have ECGs in the field experience shorter time-to-treatment

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