The role of remote ECG in prehospital medical care [FLASH]

Abstract

Introduction: The in-hospital mortality rate of ST Segment Elevation Myocardial Infarction (STEMI) is still high, due to lethal arrhythmias that are triggered by ischemic events, but it could be significantly reduced by the modern reperfusion therapy and improved secondary prophylaxis. Remote ECG support for diagnosis and therapy in acute coronary syndromes (ACSs) has been established in emergency medical services (EMS) as feasible and safe. Objectives: To evaluate the types and frequency ofheart diseases, diagnosed by EMS dispatch using remote ECG. Methods: In a retrospective study were analyzed 25195 ECG’sperformed by paramedics, when called for a cardiovascular emergency, during 2016 - 2017. The recorded ECG signals were transmitted through mobile phone to emergency dispatch, where a PC-based ECG receiving station displayed them for remote analysis and evaluation by a cardiologist. Results: A total of11449 (100%) ECG’s were transmitted and remote analyzed in 2016 and 13746 (100%) – in 2017.Atotal number of 19135 (76%) ECGs were transmitted by emergency medical assistants and 6060 (24%) ECGs - by emergency doctors. Remote analysis permitted to diagnose 163 (0,6%) cases of STE-ACS, 600 (2,3%) of NSTE-ACS, 6901 (27,4%) of cardiac arrhythmias, 8723 (34,6%) of chronic changes during two years. Early recognition of 763 cases of ACS led to timely emergency hospitalization and appropriate treatment. Conclusion: Prehospital remote ECG, carried out by paramedics and supported by physicians significantly improved quality of diagnosis in ACS, time of admission and patient survival.