title: Recognition of ST elevation by paramedics.
abstract: 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.
authors.affiliation: Resuscitation Service, Royal Hospital NHS Trust, London, UK.
authors.forename: M
authors.initials: M
authors.lastname: Whitbread
authors.forename: V
authors.initials: V
authors.lastname: Leah
authors.forename: T
authors.initials: T
authors.lastname: Bell
authors.forename: T J
authors.initials: TJ
authors.lastname: Coats
mesh_terms: D002983:Clinical Competence; D004562:Electrocardiography; D004634:Emergency Medical Technicians / Q000592:standards*; D006801:Humans; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000188:drug therapy; D015912:Thrombolytic Therapy