STUDY OBJECTIVE: In rural settings, long distances and transport times pose a challenge for achieving early reperfusion goals in patients with ST-elevation myocardial infarction (STEMI). This study investigated the association between the method of pre-hospital 12-lead ECG transmission (radio transmission vs. cellular phone transmission) and the success of transmission and legibility of 12-lead ECGs in a rural setting. METHODS: Observational study of pre-hospital 12-lead ECG transmission to the emergency department (ED) in a predominantly rural area. Success of transmission and the legibility of the 12-lead ECG were analyzed to identify barriers to 12-lead ECG transmission and reasons for failed transmission. RESULTS: Emergency medical services performed ECGs on 1140 patients, 917 of which they attempted to transmit, including 43 cases requiring emergent catheterization. Twelve-lead ECG transmission was successful in 236 (70%) of 337 radio attempts and 441 (76%) of 580 cellular attempts (difference 6.0%, 95% CI 1.1-12.1). Legibility increased from 164 (49%) of 337 radio attempts to 389 (67%) of 580 cellular attempts (difference 18.4%, 95% CI 11.8-24.9). CONCLUSION: The success of transmission and legibility of 12-lead ECGs was significantly higher with cellular technology by emergency medical service agencies in comparison to radio transmission. In rural settings with lengthy transport times, utilization of cellular technology for transmission of pre-hospital 12-lead ECGs may improve door-to-balloon times for STEMI patients.
STUDY OBJECTIVE: In rural settings, long distances and transport times pose a challenge for achieving early reperfusion goals in patients with ST-elevation myocardial infarction (STEMI). This study investigated the association between the method of pre-hospital 12-lead ECG transmission (radio transmission vs. cellular phone transmission) and the success of transmission and legibility of 12-lead ECGs in a rural setting. METHODS: Observational study of pre-hospital 12-lead ECG transmission to the emergency department (ED) in a predominantly rural area. Success of transmission and the legibility of the 12-lead ECG were analyzed to identify barriers to 12-lead ECG transmission and reasons for failed transmission. RESULTS: Emergency medical services performed ECGs on 1140 patients, 917 of which they attempted to transmit, including 43 cases requiring emergent catheterization. Twelve-lead ECG transmission was successful in 236 (70%) of 337 radio attempts and 441 (76%) of 580 cellular attempts (difference 6.0%, 95% CI 1.1-12.1). Legibility increased from 164 (49%) of 337 radio attempts to 389 (67%) of 580 cellular attempts (difference 18.4%, 95% CI 11.8-24.9). CONCLUSION: The success of transmission and legibility of 12-lead ECGs was significantly higher with cellular technology by emergency medical service agencies in comparison to radio transmission. In rural settings with lengthy transport times, utilization of cellular technology for transmission of pre-hospital 12-lead ECGs may improve door-to-balloon times for STEMI patients.
Authors: Vivek N Dhruva; Samir I Abdelhadi; Ather Anis; William Gluckman; David Hom; William Dougan; Edo Kaluski; Bunyad Haider; Marc Klapholz Journal: J Am Coll Cardiol Date: 2007-07-23 Impact factor: 24.094
Authors: Nathaniel W Niles; Sheila M Conley; Rayson C Yang; Pantila Vanichakarn; Tamara A Anderson; John R Butterly; John F Robb; John E Jayne; Norman N Yanofsky; Jean A Proehl; Donald F Guadagni; Jeremiah R Brown Journal: Prog Cardiovasc Dis Date: 2010 Nov-Dec Impact factor: 8.194
Authors: Elizabeth H Bradley; Jeph Herrin; Yongfei Wang; Barbara A Barton; Tashonna R Webster; Jennifer A Mattera; Sarah A Roumanis; Jeptha P Curtis; Brahmajee K Nallamothu; David J Magid; Robert L McNamara; Janet Parkosewich; Jerod M Loeb; Harlan M Krumholz Journal: N Engl J Med Date: 2006-11-13 Impact factor: 91.245