Department of Digital Health, Samsung Advanced Institute for Health Science & Technology (SAIHST), Sungkyunkwan University, Seoul, Republic of Korea.
Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
JMIR Mhealth Uhealth. 2021 Apr 1;9(4):e24142. doi: 10.2196/24142.
Cardiovascular disease is the leading cause of death worldwide. Early recognition, diagnosis, and reperfusion are the key elements of treatment for ST-segment elevation myocardial infarction. The absence of a prehospital 12-lead electrocardiogram (P12ECG) can cause definitive treatment delay and repeated transfer. Although guidelines highly recommend the measurement and transmission of P12ECG data, P12ECG use has not been widely established.
The aim of this study was to verify the time-efficiency and feasibility of the use of a patchy-type 12-lead ECG measuring and transmitting device (P-ECG) by an emergency medical technician (EMT) in an ambulance during patient transport.
This was a simulation-based prospective randomized crossover-controlled study that included EMTs. The participants were randomly assigned to one of two groups. Group A began the experiment with a conventional 12-lead ECG (C-ECG) device and then switched to the intervention device (P-ECG), whereas group B began the experiment with the P-ECG and then switched to the C-ECG. All simulations were performed inside an ambulance driving at 30 km/h. The time interval was measured from the beginning of ECG application to completion of sending the results. After the simulation, participants were administered the System Usability Scale questionnaire about usability of the P-ECG.
A total of 18 EMTs were recruited for this study with a median age of 35 years. The overall interval time for the C-ECG was 254 seconds (IQR 247-270), whereas the overall interval time for the P-ECG was 130 seconds (IQR 112-150), with a significant difference (P<.001). Significant differences between the C-ECG and P-ECG were identified at all time intervals, in which the P-ECG device was significantly faster in all intervals, except for the preparation interval in which the C-ECG was faster (P=.03).
Performance of 12-lead ECG examination and transmission of the results using P-ECG are faster than those of C-ECG during ambulance transport. With the additional time afforded, EMTs can provide more care to patients and transport patients more rapidly, which may help reduce the symptoms-to-balloon time for patients with acute coronary syndrome.
ClinicalTrials.gov NCT04114760; https://www.clinicaltrials.gov/ct2/show/NCT04114760.
心血管疾病是全球范围内导致死亡的主要原因。早期识别、诊断和再灌注是治疗 ST 段抬高型心肌梗死的关键要素。如果没有院前 12 导联心电图（P12ECG），则可能会导致确定性治疗延迟和反复转运。尽管指南强烈建议测量和传输 P12ECG 数据，但 P12ECG 的使用尚未得到广泛确立。
本研究旨在验证在救护车转运过程中，急救医疗技术员（EMT）使用贴片式 12 导联心电图测量和传输设备（P-ECG）的时间效率和可行性。
这是一项基于模拟的前瞻性随机交叉对照研究，纳入了 EMT 作为研究对象。参与者被随机分配到两组之一。组 A 首先使用常规 12 导联心电图（C-ECG）设备进行实验，然后切换到干预设备（P-ECG），而组 B 首先使用 P-ECG 进行实验，然后切换到 C-ECG。所有模拟均在以 30 公里/小时行驶的救护车内部进行。时间间隔从开始应用心电图到完成发送结果的时间进行测量。模拟结束后，参与者使用系统可用性量表对 P-ECG 的可用性进行了问卷调查。
共有 18 名 EMT 参与了这项研究，中位年龄为 35 岁。C-ECG 的总时间间隔为 254 秒（IQR 247-270），而 P-ECG 的总时间间隔为 130 秒（IQR 112-150），差异具有统计学意义（P<.001）。在所有时间间隔内，C-ECG 和 P-ECG 之间均存在显著差异，除了准备间隔内 C-ECG 更快（P=.03）之外，在所有间隔内 P-ECG 设备都更快。
在救护车转运过程中，使用 P-ECG 进行 12 导联心电图检查和结果传输比 C-ECG 更快。通过额外的时间，EMT 可以为患者提供更多的护理，并更快地转运患者，这可能有助于缩短急性冠状动脉综合征患者的症状至球囊时间。
ClinicalTrials.gov NCT04114760；https://www.clinicaltrials.gov/ct2/show/NCT04114760。
