title: Paramedics as decision makers on the activation of the catheterization laboratory in the presence of acute ST-elevation myocardial infarction.
abstract: METHODS
  To minimize delays in time to reperfusion in an urban-suburban North Carolina County, Guilford County Emergency Medical Services (EMS) and Moses Cone Hospital, Greensboro, NC, have collaborated to use the acquisition of 12-lead electrocardiographs and their paramedic interpretation to initiate the catheterization laboratory team and cardiologist; independent of over read by a physician. The study population of 91 patients was divided into the catheterization laboratory activation by EMS and catheterization laboratory activation by the emergency department physician (ED-MD) groups, and also by EMS and self-transported groups.
  
  
  RESULTS
  The EMS group had shorter median time intervals from hospital door to percutaneous coronary intervention (PCI) with balloon inflation than those patients who self-transported to the hospital. Also, patients who were treated during the EMS activation of the catheterization laboratory phase had shorter median hospital door to PCI times than those who were treated during ED-MD activation of the catheterization laboratory.
  
  
  CONCLUSIONS
  The time from hospital arrival to PCI with balloon inflation was significantly shorter during the period in which EMS activated the catheterization laboratory than during the period the laboratory was activated by hospital staff. Thus, paramedics with quality electrocardiogram interpretation training and education can identify patients with acute ST-elevation myocardial infarction and properly activate the catheterization laboratory.
authors.affiliation: Guilford County Emergency Medical Services, 1002 Meadowood Street, Greensboro, NC 27409, USA. dwayne.young@guilford-es.com
authors.forename: Dwayne R
authors.initials: DR
authors.lastname: Young
authors.forename: Marc
authors.initials: M
authors.lastname: Murinson
authors.forename: Charles
authors.initials: C
authors.lastname: Wilson
authors.forename: Belinda
authors.initials: B
authors.lastname: Hammond
authors.forename: Mary
authors.initials: M
authors.lastname: Welch
authors.forename: Vicki
authors.initials: V
authors.lastname: Block
authors.forename: Sheryl
authors.initials: S
authors.lastname: Booth
authors.forename: William
authors.initials: W
authors.lastname: Tedder
authors.forename: Karen
authors.initials: K
authors.lastname: Dolby
authors.forename: Jackie
authors.initials: J
authors.lastname: Roh
authors.forename: Robert
authors.initials: R
authors.lastname: Beaton
authors.forename: John
authors.initials: J
authors.lastname: Edmunds
authors.forename: Mark
authors.initials: M
authors.lastname: Young
authors.forename: Vermell
authors.initials: V
authors.lastname: Rice
authors.forename: Cheryl
authors.initials: C
authors.lastname: Somers
authors.forename: Robin
authors.initials: R
authors.lastname: Edwards
authors.forename: Charles
authors.initials: C
authors.lastname: Maynard
authors.forename: Galen S
authors.initials: GS
authors.lastname: Wagner
mesh_terms: D006328:Cardiac Catheterization / Q000706:statistics & numerical data*; D003657:Decision Making; D004562:Electrocardiography / Q000706:statistics & numerical data*; D004634:Emergency Medical Technicians / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000628:therapy*; D009657:North Carolina; D013996:Time and Motion Studies; D014218:Triage / Q000379:methods* / Q000706:statistics & numerical data*