Our work on Pre-Hospital ECGs is currently being considered by
the BMJ and the JAEM, based on about 2 years experience
Our findings in summary are that paramedics can recognise the
ECG criteria for thrombolysis (being slightly better than A&E
SHOs), that a pre-alert to the hospital gives a benefit if the hospital
is poorly organised, but no benefit if the hospital is efficient. If all
hospitals achieve the NSF target for thrombolysis a pre-hospital
ECG will be on no benefit without pre-hospital thrombolysis. Even in
an urban area pre-hospital thrombolysis would give a clinically
significant decrease in pain to needle time.
The next phase of this research needs to be to establish if
paramedics can make a diagnosis of AMI rather than just recognise
the ECG criteria for thrombolysis.
Tim.
> What is the feeling amongst the group, about pre-hospital ECGs?
>
> Within the National Service Framework on 'heart attack & other acute
> coronary syndromes', we are to improve our 'door to needle times' as
> well as 'call to needle'.
>
> Could we maximise the time involved and perform pre-hospital ECGs?
>
> What do the pre-hospital people feel?
>
> Regards
>
> Adrian Kerner
> SpR
> Leeds
>
Timothy J Coats MD FRCS FFAEM
Senior Lecturer in Accident and Emergency / Pre-Hospital Care
Royal London Hospital, UK.
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