Recognition of ST elevation by paramedics.
OBJECTIVE
To define the ability of UK paramedics to recognise ST segment elevation using a prehospital 12 lead electrocardiogram (ECG).


METHODS
Analysis of the diagnostic ability of seven paramedics 12 months after a two day training course, using interpretation of a 12 lead ECG by two cardiologists as the criterion standard. Comparison of paramedic and A&E SHO diagnosis to determine accuracy, specificity, sensitivity, negative predictive value, and positive predictive value of paramedic interpretation.


RESULTS
Paramedics showed a median accuracy of 0.95 (95% CI 0.88 to 0.98), a specificity of 0.91 (95% CI 0.53 to 1.0), a sensitivity of 0.97 (95% CI 0.94 to 0.99), a NPV of 0.77 (95% CI 0.62 to 0.92) and a PPV of 0.99 (95% CI 0.92 to 1.0). This was not significantly different from a group of experienced A&E SHOs.


CONCLUSIONS
UK paramedics can recognise ST elevation using a 12 lead ECG. Radio transmission of an ECG may not be necessary to pre-alert the hospital.
Whitbread
M
M
Resuscitation Service, Royal Hospital NHS Trust, London, UK.
Leah
V
V
Bell
T
T
Coats
T J
TJ
D002983:Clinical Competence; D004562:Electrocardiography; D004634:Emergency Medical Technicians / Q000592:standards*; D006801:Humans; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000188:drug therapy; D015912:Thrombolytic Therapy