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Pre-hospital ECG reduced scene, transport times for patients with STEMI
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A study has found that pre-hospital ECG for patients with chest pain minimally prolongs scene and transport times, but reduces those times for patients with STEMI, potentially reducing total ischemic time.
Mitul Patel, MD, and researchers reviewed City of San Diego Emergency Medical System runsheets of 21,742 patients with chest pain, comparing on-scene times and transport times from January 2003 to December 2005, when pre-hospital ECG wasn’t performed, and from January 2006 to April 2008, when it was performed. Median scene times and transport times were compared in patients with and without STEMI.
Pre-hospital ECG resulted in minimal increases in median scene time (19 minutes and 10 seconds vs. 19 minutes and 28 seconds; P=.002) and transport time (13 minutes and 16 seconds vs. 13 minutes and 28 seconds; P=.007). However, compared with patients with chest pain, patients with STEMI had a shorter median scene time (17 minutes and 51 seconds vs. 19 minutes and 31 seconds, P=.001), transport time (12 minutes and 34 seconds vs. 13 minutes and 31 seconds; P=.006) and scene-to-hospital time (30 minutes and 45 seconds vs. 33 minutes and 29 seconds; P=.001).
“[T]he reduction in door-to-reperfusion time with PH [pre-hospital] ECG is not at the expense of delays in obtaining the PH 12-lead ECG at the scene by EMS. Implementing a PH ECG adds trivial delay to the total time EMS personnel spend on patients with chest pain. These findings support the use of PH ECG for all EMS response patients experiencing chest pain,” the authors concluded.
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