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12-Lead Electrocardiograms Acquired and Transmitted by Emergency Medical Technicians are of Diagnostic Quality and Positively Impact Patient Care

Published online by Cambridge University Press:  29 October 2020

Vladimir Kotelnik ,
Kevin Pesce ,
William M. Masterton ,
Robert T. Marshall ,
Gregson Pigott ,
Nathaniel Bialek ,
Jason Winslow  and
Lauren M. Maloney Open the ORCID record for Lauren M. Maloney [Opens in a new window]
Vladimir Kotelnik
Affiliation:
Department of Emergency Medicine, Stony Brook University Hospital, Stony Brook, New YorkUSA
Kevin Pesce
Affiliation:
Department of Emergency Medicine, Stony Brook University Hospital, Stony Brook, New YorkUSA
William M. Masterton
Affiliation:
Suffolk County Department of Health Services, Yaphank, New YorkUSA
Robert T. Marshall
Affiliation:
Department of Emergency Medicine, Stony Brook University Hospital, Stony Brook, New YorkUSA
Gregson Pigott
Affiliation:
Suffolk County Department of Health Services, Yaphank, New YorkUSA
Nathaniel Bialek
Affiliation:
Suffolk County Department of Health Services, Yaphank, New YorkUSA
Jason Winslow
Affiliation:
Suffolk County Department of Health Services, Yaphank, New YorkUSA
Lauren M. Maloney*
Affiliation:
Department of Emergency Medicine, Stony Brook University Hospital, Stony Brook, New YorkUSA
*
Correspondence: Lauren M. Maloney, MD, NRP, FP-C, NCEE Stony Brook University Hospital Department of Emergency Medicine HSC Level 4 Room 050 Stony Brook, New York11794-8350USA E-mail: [email protected]
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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.

Keywords

12-lead electrocardiogramEmergency Medical Servicesemergency medical technicianprehospitalSTEMI
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 36 , Issue 1 , February 2021 , pp. 47 - 50
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Copyright
© The Author(s), 2020. Published by Cambridge University Press on behalf of the World Association for Disaster and Emergency Medicine

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