Abstract P182: Usefulness of Mobile Telemedicine System in Real-time Transmission of Out-of-hospital 12-lead ECG

Abstract

[Purpose] AHA/ACC guidelines recommend routine use of 12-lead ECG and advance notification for patients with acute coronary syndrome. However, transmission of out-of-hospital 12-lead ECG to emergency department is still not spread and ECG interpretation on the prehospital and emergency department is not established. Therefore, we have developed and tested the clinical usefulness of the mobile telemedicine system to transmit 12-lead ECG between moving ambulances and physicians in cardiovascular emergency. [Method] We set up the mobile telemedicine using the third-generation digital mobile phone to promote communications between an ambulance and diverse hospital. Compatibility issue among device vendors was solved by the implementation of open-standard medical waveform encoding rule with motion noise-reduction system. Real time 12-lead ECG was transferred together with vital signs and live video during transfer the patient by an ambulance. The performance of the mobile telemedicine system in the field-test was checked to transfer 12-lead ECG in different scenarios such as transferred ECG from a volunteer moving hand or leg, coughing or twisting body in an ambulance driving on common road or highway. In the next step, we set up the mobile telemedicine on an ambulance to promote communications between moving 5 ambulances in Suita-city and National Cardiovascular Center since 2008 June 2. To establish the efficacy of real-time transmission of out-of-hospital 12-lead ECG, the time-line from the onset of acute myocardial infarction to reperfusion is analyzed. [Results] Totally 36 patters of 12-lead ECG were checked in the field test and all of them were comparable than those original one in the ambulance. Time-delay for transmission of 12 lead ECG was within 10seconds and for one-lead ECG monitoring and vital signs including BP, HR and oxygen saturation was 1 second without the difficulties for the interpretation. [Conclusion] Those results indicate the usefulness and reliability of transmission of 12-lead ECG using the mobile telemedicine system from the ambulance. Further investigation is on-going to determine the efficacy in clinical conditions to reduce the treatment delay for acute myocardial infarction.