Prehospital 12-lead electrocardiogram for patients with chest pain: a pilot study.

Autor:	Cheung KS; Department of Accident and Emergency, Queen Mary Hospital, Pokfulam, Hong Kong., Leung LP; Emergency Medicine Unit, The Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong., Siu YC; Medical Director, Fire and Ambulance Services Academy, Hong Kong Fire Services Department, Hong Kong., Tsang TC; Department of Accident and Emergency, Queen Mary Hospital, Pokfulam, Hong Kong., Tsui MS; Department of Accident and Emergency, Queen Mary Hospital, Pokfulam, Hong Kong., Tam CC; Department of Medicine, Queen Mary Hospital, Pokfulam, Hong Kong., Chan RH; Honorary Consultant Cardiologist, Hong Kong Sanatorium Hospital, Happy Valley, Hong Kong.
Jazyk:	angličtina
Zdroj:	Hong Kong medical journal = Xianggang yi xue za zhi [Hong Kong Med J] 2018 Oct; Vol. 24 (5), pp. 484-491.
DOI:	10.12809/hkmj177135
Abstrakt:	Introduction: After ST-segment elevation myocardial infarction (STEMI), it is vital to shorten reperfusion time. This study examined data from a pilot project to shorten the door-to-balloon (D2B) time by using prehospital 12-lead electrocardiogram (ECG). Methods: Fifteen ambulances equipped with X Series ® Monitor/Defibrillator (Zoll Medical Corporation) were deployed to the catchment area of Queen Mary Hospital, Hong Kong, from November 2015 to December 2016. For patients with chest pain, prehospital 12-lead ECG was performed and tele-transmitted to attending physicians at the accident and emergency department for immediate interpretation. The on-call cardiologist was called before patient arrival if STEMI was suspected. Data from this group of patients with STEMI were compared with data from patients with STEMI who were transported by ambulances without prehospital ECG or by self-arranged transport. Results: From 841 patients with chest pain, 731 gave verbal consent and prehospital ECG was performed and transmitted. Of these, 25 patients with clinically diagnosed STEMI required emergency coronary angiogram with or without primary percutaneous coronary intervention. The mean D2B time for these 25 patients (93 minutes) was significantly shorter (P=0.003) than that for 58 patients with STEMI transported by ambulances without prehospital ECG (112 minutes) and that for 41 patients with STEMI with self-arranged transport (138 minutes). However, shorter reperfusion time was only recorded during daytime hours (08:00-17:59). No statistically significant difference in 30-day mortality was found. Conclusion: Prehospital ECG is technologically feasible in Hong Kong and shortens the D2B time. However, shorter reperfusion time was only recorded during daytime hours.
Databáze:	MEDLINE
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