title: Prehospital triage of acute myocardial infarction: wireless transmission of electrocardiograms to the on-call cardiologist via a handheld computer.
abstract: 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.
authors.affiliation: NorthEast Medical Center, Concord, NC 27705, USA.
authors.forename: Paul T
authors.initials: PT
authors.lastname: Campbell
authors.forename: Janet
authors.initials: J
authors.lastname: Patterson
authors.forename: Deedee
authors.initials: D
authors.lastname: Cromer
authors.forename: Karen
authors.initials: K
authors.lastname: Wall
authors.forename: George L
authors.initials: GL
authors.lastname: Adams
authors.forename: Alfred
authors.initials: A
authors.lastname: Albano
authors.forename: Craig
authors.initials: C
authors.lastname: Corey
authors.forename: Paula
authors.initials: P
authors.lastname: Fox
authors.forename: Jim
authors.initials: J
authors.lastname: Gardner
authors.forename: Barry
authors.initials: B
authors.lastname: Hawthorne
authors.forename: Jonathan
authors.initials: J
authors.lastname: Lipton
authors.forename: Maria
authors.initials: M
authors.lastname: Sejersten
authors.forename: Alan
authors.initials: A
authors.lastname: Thompson
authors.forename: Amanda
authors.initials: A
authors.lastname: Thompson
authors.forename: Susan
authors.initials: S
authors.lastname: Wilfong
authors.forename: Charles
authors.initials: C
authors.lastname: Maynard
authors.forename: Galen
authors.initials: G
authors.lastname: Wagner
mesh_terms: 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*