Abstract 307: Transmission of Prehospital 12-Lead ECGs Significantly Reduces Time of Emergency Department Arrival to Arrival in the Angiography Suite and Door-to-Balloon Time in Patients with a STEMI
Studies have shown that EMS obtained pre-hospital 12 Lead ECG’s have a positive impact on the treatment and mortality of patients experiencing an acute myocardial infarction. Many PCI centers do not have cardiac angiography staff in house 24/7. The response and prep time to bring an angiography suite to functional readiness is at least 20 minutes during the off hours.
To assess our hypothesis that transmission of the pre-hospital 12 Lead ECGs decreases door to balloon time for patients experiencing a STEMI and decreases time spent in the Emergency Department.
All STEMI patients that presented via EMS to an urban Hospital between January 1, 2010 and December 31, 2011 and went to the cardiac angiography suite were reviewed. Analysis was performed to investigate the relationship on door to balloon time and time spent in the Emergency Department between transmissions vs. non-transmission of the pre-hospital 12 lead ECG.
Of all STEMI patients that presented via EMS in 2010 - 2011 (N=83), 59.0% had a pre-hospital notification of the STEMI resulting in an average door to balloon time of 36.4 minutes (p-value of 0.0008). The STEMI patients that arrived via EMS without transmission of the 12 Lead ECG had a longer average door to balloon time of 53.2 minutes (p-value of 0.0004). There was not a statistical difference in the average EMS on scene time between the groups (11 minutes for the transmission group and 13 minutes for the non-transmission group). There was a 28.1 minute reduction in the time of arrival in the Emergency Department to arrival in the angiography suite time for the patient in which a pre-hospital 12 Lead ECG was transmitted (9.9 minutes for the transmission group vs. 38.0 minutes for the non-transmission group, p-value of 0.000002).
Transmission of the pre-hospital 12 Lead ECG for patients experiencing a STEMI significantly decreases the time from arrival in the Emergency Department to arrival in the angiography suite and decreases the overall door to balloon time for those patients. The time saved with transmission of the pre-hospital 12 ECG for patients experiencing a STEMI facilitates by-passing the Emergency Department, allowing a STEMI patient to go directly to the cardiac angiography suite.
- © 2012 by American Heart Association, Inc.