Mobile telemetry for pre-hospital thrombolysis: problems and solutions.

In the Angus region of Scotland, we have used mobile telemetry to facilitate pre-hospital thrombolysis by paramedic staff. An initial survey demonstrated that connection could be achieved in all but three locations. In the first year of operation, 229 contacts were received. Communication between the ambulance and the base station failed on four occasions (2%). Problems with transmission of an electrocardiogram (ECG) were encountered on 37 occasions (16%). The median time for acquisition and transmission of an ECG was 22 min. This compares with a median time of 59 min for first ECG in a control group from similar locations, who were assessed in hospital. Telemetry offers essential back-up to paramedics adopting a challenging and extended role. Strategies can be developed to deal with signal strength and equipment failure.