Abstract
BackgroundCardiovascular disease is the leading cause of death worldwide. Early recognition, diagnosis, and reperfusion are the key elements of treatment for ST-segment elevation myocardial infarction. The absence of a prehospital 12-lead electrocardiogram (P12ECG) can cause definitive treatment delay and repeated transfer. Although guidelines highly recommend the measurement and transmission of P12ECG data, P12ECG use has not been widely established.ObjectiveThe aim of this study was to verify the time-efficiency and feasibility of the use of a patchy-type 12-lead ECG measuring and transmitting device (P-ECG) by an emergency medical technician (EMT) in an ambulance during patient transport.MethodsThis was a simulation-based prospective randomized crossover-controlled study that included EMTs. The participants were randomly assigned to one of two groups. Group A began the experiment with a conventional 12-lead ECG (C-ECG) device and then switched to the intervention device (P-ECG), whereas group B began the experiment with the P-ECG and then switched to the C-ECG. All simulations were performed inside an ambulance driving at 30 km/h. The time interval was measured from the beginning of ECG application to completion of sending the results. After the simulation, participants were administered the System Usability Scale questionnaire about usability of the P-ECG.ResultsA total of 18 EMTs were recruited for this study with a median age of 35 years. The overall interval time for the C-ECG was 254 seconds (IQR 247-270), whereas the overall interval time for the P-ECG was 130 seconds (IQR 112-150), with a significant difference (P<.001). Significant differences between the C-ECG and P-ECG were identified at all time intervals, in which the P-ECG device was significantly faster in all intervals, except for the preparation interval in which the C-ECG was faster (P=.03).ConclusionsPerformance of 12-lead ECG examination and transmission of the results using P-ECG are faster than those of C-ECG during ambulance transport. With the additional time afforded, EMTs can provide more care to patients and transport patients more rapidly, which may help reduce the symptoms-to-balloon time for patients with acute coronary syndrome.Trial RegistrationClinicalTrials.gov NCT04114760; https://www.clinicaltrials.gov/ct2/show/NCT04114760
Highlights
Background and SignificanceCardiovascular disease (CVD) is the leading cause of death worldwide [1]
A total of 18 emergency medical technician (EMT) were recruited for this study with a median age of 35 years
Significant differences between the conventional 12-lead ECG (C-ECG) and patchy-type 12-lead ECG measuring and transmitting device (P-ECG) were identified at all time intervals, in which the P-ECG device was significantly faster in all intervals, except for the preparation interval in which the C-ECG was faster (P=.03)
Summary
Cardiovascular disease (CVD) is the leading cause of death worldwide [1]. In 2017, there were 17.9 million deaths resulting from CVD, more than three-quarters of which occurred in lowor middle-income countries [2]. Deaths caused by ischemic heart disease have risen by about 19%-20% over the past 10 years. To reduce the total ischemic time, as a major factor in short- and long-term mortality [1,4,5], early recognition, diagnosis, and reperfusion should be performed in a coordinated and complementary manner. Cardiovascular disease is the leading cause of death worldwide. Diagnosis, and reperfusion are the key elements of treatment for ST-segment elevation myocardial infarction. The absence of a prehospital 12-lead electrocardiogram (P12ECG) can cause definitive treatment delay and repeated transfer. Guidelines highly recommend the measurement and transmission of P12ECG data, P12ECG use has not been widely established
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