Prehospital triage of acute myocardial infarction: wireless transmission of electrocardiograms to the on-call cardiologist via a handheld computer.
BACKGROUND
Use of intravenous fibrinolytic agents and percutaneous coronary interventions produce the greatest benefit when they are implemented in the first 2 hours after symptom onset. Further delays in the time to treatment typically lead to reduced benefits and poorer outcomes.


METHODS
Cabarrus County Emergency Medical Service personnel complete an acute myocardial infarction case report form and assess a 12-lead electrocardiogram (ECG) to determine if ST elevation of at least 1 mV in at least 2 contiguous leads is present and then to transmit the ECG wirelessly to the emergency department (ED). The ECG is then forwarded wirelessly from the ED to the on-call cardiologist who is carrying the IPAQ handheld computer.


RESULTS
Five representative patients managed using this system during the initial year of its implementation are presented.


CONCLUSIONS
The examples included in this article illustrate that the system and technology can work if applied in a coordinated fashion using multiple disciplines including emergency medical service, cardiologists, ED personnel, and the hospital cardiac care team, which includes the catheterization laboratory call team, acute coronary care nurses, and clerical support staff.
Campbell
Paul T
PT
NorthEast Medical Center, Concord, NC 27705, USA.
Patterson
Janet
J
Cromer
Deedee
D
Wall
Karen
K
Adams
George L
GL
Albano
Alfred
A
Corey
Craig
C
Fox
Paula
P
Gardner
Jim
J
Hawthorne
Barry
B
Lipton
Jonathan
J
Sejersten
Maria
M
Thompson
Alan
A
Thompson
Amanda
A
Wilfong
Susan
S
Maynard
Charles
C
Wagner
Galen
G
D000328:Adult; D016507:Cardiology Service, Hospital / Q000458:organization & administration; D034201:Computers, Handheld; D004562:Electrocardiography / Q000295:instrumentation / Q000379:methods*; D004632:Emergency Medical Services / Q000379:methods; D004867:Equipment Design; D019544:Equipment Failure Analysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000628:therapy*; D009657:North Carolina; D019114:Remote Consultation / Q000295:instrumentation / Q000379:methods*; D013686:Telemetry / Q000295:instrumentation / Q000379:methods*; D014218:Triage / Q000379:methods*