From Canadian Journal of Cardiology. Timeline of events in chest pain assessment by emergency medical services (EMS) depicting traditional assessment and transportation to hospital emergency room vs bypass created by Cardiac Outcomes Through Digital Evaluation (CODE) STEMI project. (A) More rapid diagnosis of STEMI and earlier transfer to catheterization laboratory for PPCI. (B) More rapid diagnosis of STEMI with earlier administration of thrombolysis vs traditional patient assessment and management in hospital. ECG, electrocardiogram; PHL, prehospital thrombolytic; PPCI, primary percutaneous coronary intervention; STEMI, ST-elevation myocardial infarction.
A mobile technology allowing for immediate review of ECGs in the field has led to faster treatment of heart attacks and has saved many lives. Myocardial infarction (MI) is a leading cause of death in both men and women in the United States. Standards of care in treating acute MI include administration of thrombolytics within 30 minutes of symptoms and/or cardiac catheterization within 90 minutes. Unfortunately, these quality measures are often not met due to constraints such as travel time to the clinic.
Investigators at the University of Manitoba in Canada have addressed this issue by pioneering a strategy whereby trained emergency medical technicians (EMTs) who suspect a heart attack can transmit the patient’s ECG to a physician’s mobile phone. After confirming that the patient is indeed having a heart attack, the physician instructs the EMTs to initiate thrombolysis or to alert the catheterization lab to get ready. Furthermore, the number of false positive test results has decreased, improving resource allocation and potentially saving millions of dollars in unneeded procedures. Published recently in the Canadian Journal of Cardiology, results of the study showed that the program doubled the number of patients who received appropriate thrombolysis. Furthermore, the number who received appropriate catheterization increased by nearly 7-fold. The authors now recommend that this “Cardiac Outcomes Through Digital Evaluation (CODE) STEMI” program be the standard of care in ER settings.
Abstract in Canadian Journal of Cardiology: Cardiac Outcomes Through Digital Evaluation (CODE) STEMI Project: Prehospital Digitally-Assisted Reperfusion Strategies
More form Elsevier: ECGs Administered by Paramedics Can Speed Treatment for Severe Heart Attacks
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