A prospective evaluation of prehospital 12-lead ECG application in chest pain patients.
The objective of this study was to prospectively determine the utility, efficiency, and reliability of early prehospital 12-lead electrocardiogram (ECG) application, the improvement in prehospital diagnostic accuracy, and paramedic and base physician opinions regarding early application of prehospital 12-lead ECGs in a broad range of stable chest pain patients. The patient population consisted of cooperative, stable adult prehospital patients with a chief complaint of nontraumatic chest pain of presumed ischemic origin. From July 17, 1989 through January 1, 1990 paramedics acquired prehospital 12-lead ECGs on 680 stable adult chest pain patients. Factors affecting prehospital 12-lead ECG application were evaluated. Paramedic application of prehospital 12-lead ECGs was found to be efficient and reliable, and it can be applied to most cooperative stable adult prehospital chest pain patients. Prehospital 12-lead ECGs significantly improve base physicians' diagnostic accuracy in myocardial infarction, angina, and nonischemic chest pain patients. Paramedic and base physicians' opinions regarding early application of prehospital 12-lead ECGs during patient evaluation were favorable.
Aufderheide
T P
TP
Department of Emergency Medicine, Medical College of Wisconsin, Milwaukee 53226.
Hendley
G E
GE
Woo
J
J
Lawrence
S
S
Valley
V
V
Teichman
S L
SL
D002637:Chest Pain / Q000175:diagnosis*; D004562:Electrocardiography / Q000379:methods*; D004632:Emergency Medical Services; D004634:Emergency Medical Technicians; D005069:Evaluation Studies as Topic; D006801:Humans; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011994:Recombinant Proteins / Q000627:therapeutic use; D012680:Sensitivity and Specificity; D013686:Telemetry; D015912:Thrombolytic Therapy; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use
D011994:Recombinant Proteins; D010959:Tissue Plasminogen Activator