Performance of a New “Physician-Less” Automated System of Prehospital ST-Segment Elevation Myocardial Infarction Diagnosis and Catheterization Laboratory Activation

The door-to-balloon times frequently exceed the recommended delay. We therefore evaluated the performance of a novel “physician-less” cardiac catheterization laboratory (CCL) activation system relying on the automated electrocardiographic diagnosis alone. From January 2010 to 2012, first responders...

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Bibliographic Details
Published in:The American journal of cardiology 2013-07, Vol.112 (2), p.156-161
Main Authors: Potter, Brian J., MDCM, Matteau, Alexis, MD, SM, Mansour, Samer, MD, Essiambre, Richard, MD, Montigny, Martine, MD, Savoie, Sylvie, RN, Gobeil, François, MD
Format: Article
Language:English
Subjects:
Aged
Automation
Cardiac Catheterization
Cardiology
Cardiovascular
Cardiovascular disease
Coronary vessels
Electrocardiography
Emergency Medical Services - methods
Female
Heart attacks
Hospitals
Humans
Male
Middle Aged
Myocardial Infarction - diagnosis
Myocardial Infarction - therapy
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Summary:The door-to-balloon times frequently exceed the recommended delay. We therefore evaluated the performance of a novel “physician-less” cardiac catheterization laboratory (CCL) activation system relying on the automated electrocardiographic diagnosis alone. From January 2010 to 2012, first responders performed electrocardiograms in the field for all patients with a complaint of chest pain or dyspnea. An automated machine diagnosis of “acute myocardial infarction” resulted in immediate CCL activation and direct transfer without human reinterpretation or transmission of the electrocardiogram. Any activation resulting from a nondiagnostic ECG (no ST-segment elevation) was deemed inappropriate and classified as resulting from either human or machine error. Of 155 activations, 136 (88%) were electrocardiographically appropriate. Of these, 128 patients had a final diagnosis of ST-segment elevation myocardial infarction. A door-to-balloon time of
ISSN:0002-9149
1879-1913
DOI:10.1016/j.amjcard.2013.03.005