Transmission of 12-lead electrocardiographic tracings by Emergency Medical Technician-Basics and Emergency Medical Technician-Intermediates: a feasibility study

Am J Emerg Med. 2011 May;29(4):437-40. doi: 10.1016/j.ajem.2010.01.015. Epub 2010 May 4.

Abstract

Introduction: Prehospital transmission of the electrocardiogram (ECG) in ST-elevation myocardial infarction patients has been shown to reduce door to treatment time and improve outcome. Acquisition of the ECG tracing is a paramedic skill, thus limiting the benefit of early ECG transmission to primarily urban areas. The purpose of this investigation was to determine whether prehospital ECGs could be transmitted by nonparamedic personnel.

Methods: A prospective case series of consecutive patients with a chief complaint of chest pain was conducted. An ECG was transmitted on all eligible patients. Proper lead placement was verified, and the diagnostic quality of the ECG was assessed on emergency department arrival. Time on scene was recorded and compared with historical controls.

Results: Ninety patients were enrolled in the study. An ECG was transmitted successfully in 89 (98.9%) of 90 patients. Accurate lead placement was noted in 89 (98.9%) of 90, and the ECG was of "diagnostic quality" in 85 (95.5%) of 89 patients. There was no increase in scene time during the study period.

Conclusion: Prehospital transmission of diagnostic-quality ECG can be reliably performed by nonparamedic providers.

MeSH terms

  • Adult
  • Clinical Competence*
  • Cohort Studies
  • Early Diagnosis
  • Electrocardiography*
  • Emergency Medical Services*
  • Emergency Medical Technicians*
  • Feasibility Studies
  • Humans
  • Myocardial Infarction / diagnosis*
  • Reproducibility of Results
  • Rural Health Services*