title: The prehospital 12-lead electrocardiogram's effect on time to initiation of reperfusion therapy: a systematic review and meta-analysis of existing literature.
abstract: The prehospital electrocardiogram (ECG) is becoming the standard of care of suspected cardiac chest pain. We evaluated the evidence regarding the prehospital ECG and sought to quantify the reduction in time to reperfusion therapy attributable to the prehospital ECG. We conducted a systematic review and analyzed studies that were conducted in emergency medical systems relevant to providers in the United States. The papers were limited to studies that reported original data that compared prehospital ECG to no prehospital ECG groups. Four studies containing 99 patients met the inclusion criteria. A meta-analysis of these studies revealed a difference of 24.7 (95% confidence interval, 16.7-32.7) minutes. Providers now have a quantified value of the prehospital ECG based on the best published evidence. In addition, this search showed a relatively low quality and quantity of research on the prehospital ECG.
authors.affiliation: School of Medicine, University of New Mexico, Albuquerque 87131, USA. abrainard@salud.unm.edu
authors.forename: Andrew Han
authors.initials: AH
authors.lastname: Brainard
authors.forename: William
authors.initials: W
authors.lastname: Raynovich
authors.forename: Dan
authors.initials: D
authors.lastname: Tandberg
authors.forename: Edward J
authors.initials: EJ
authors.lastname: Bedrick
mesh_terms: D016001:Confidence Intervals; D003327:Coronary Disease / Q000175:diagnosis / Q000628:therapy; D004562:Electrocardiography; D004632:Emergency Medical Services; D006801:Humans; D009203:Myocardial Infarction / Q000175:diagnosis / Q000628:therapy; D011787:Quality of Health Care; D013997:Time Factors