Prehospital triage of acute myocardial infarction: wireless transmission of electrocardiograms to the on-call cardiologist via a handheld computer

Use of intravenous fibrinolytic agents and percutaneous coronary interventions produce the greatest benefit when they are implemented in the first 2 hours after symptom onset. Further delays in the time to treatment typically lead to reduced benefits and poorer outcomes. Cabarrus County Emergency Me...

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Bibliographic Details
Published in:Journal of electrocardiology 2005-10, Vol.38 (4), p.300-309
Main Authors: Campbell, Paul T., Patterson, Janet, Cromer, Deedee, Wall, Karen, Adams, George L., Albano, Alfred, Corey, Craig, Fox, Paula, Gardner, Jim, Hawthorne, Barry, Lipton, Jonathan, Sejersten, Maria, Thompson, Alan, Thompson, Amanda, Wilfong, Susan, Maynard, Charles, Wagner, Galen
Format: Article
Language:English
Subjects:
Adult
Cardiology Service, Hospital - organization & administration
Computers, Handheld
Electrocardiogram
Electrocardiography - instrumentation
Electrocardiography - methods
Emergency department
Emergency Medical Services - methods
Equipment Design
Equipment Failure Analysis
Humans
Male
Middle Aged
Myocardial infarction
Myocardial Infarction - diagnosis
Myocardial Infarction - therapy
North Carolina
Remote Consultation - instrumentation
Remote Consultation - methods
Telemetry - instrumentation
Telemetry - methods
Triage - methods
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Summary:Use of intravenous fibrinolytic agents and percutaneous coronary interventions produce the greatest benefit when they are implemented in the first 2 hours after symptom onset. Further delays in the time to treatment typically lead to reduced benefits and poorer outcomes. Cabarrus County Emergency Medical Service personnel complete an acute myocardial infarction case report form and assess a 12-lead electrocardiogram (ECG) to determine if ST elevation of at least 1 mV in at least 2 contiguous leads is present and then to transmit the ECG wirelessly to the emergency department (ED). The ECG is then forwarded wirelessly from the ED to the on-call cardiologist who is carrying the IPAQ handheld computer. Five representative patients managed using this system during the initial year of its implementation are presented. The examples included in this article illustrate that the system and technology can work if applied in a coordinated fashion using multiple disciplines including emergency medical service, cardiologists, ED personnel, and the hospital cardiac care team, which includes the catheterization laboratory call team, acute coronary care nurses, and clerical support staff.
ISSN:0022-0736
1532-8430
DOI:10.1016/j.jelectrocard.2005.05.003