The role of paramedics in a primary PCI program for ST-elevation myocardial infarction.

Time to reperfusion is linked to survival in patients presenting with ST-elevation myocardial infarction (STEMI). Primary percutaneous coronary intervention (PCI) is now considered the dominant strategy when it can be performed quickly. Because the number of cardiac catherization facilities is limited, health care workers have attempted to develop systems to ensure access to primary PCI for all patients with STEMI. The pre-hospital ECG has been shown to be a valuable tool to identify STEMI early and its use in the field has allowed paramedics to alert the medical team of an incoming patient with STEMI. Paramedics have come to play an important role in the early identification of patients with STEMI who make use of the emergency medical services. We review evidence that supports the role of the paramedics in patients presenting with STEMI.