Sending patient information to doctors before an ambulance even arrives can substantially cut the time heart attack patients need to wait before receiving a potentially life-saving procedure, according to a new study.
When emergency medical technicians transmit electrocardiograms directly to a cardiologists handheld device, heart attack patients can potentially receive direct clot removal in half the usual time. Thats what cardiologists at Duke University Medical Center and NorthEast Medical Center in Concord, N.C., found in a recent study.
Cutting this time is critical because the sooner a patient who has suffered a heart attack receives an artery-opening procedure, the more likely heart muscle can be saved, and that may help the patient to survive.
While the American College of Cardiology and the American Heart Association recommend that heart attack patients have their arteries opened within 90 minutes of arriving at the hospital, the NorthEast Medical Center team was able to cut that time to 50 minutes. The national average is about 100 minutes, the researchers said.
"We found that the pre-hospital wireless transmission of an ECG directly to a cardiologists hand-device significantly reduced the time," said the lead researcher, George Adams, M.D. "When the cardiologist can directly see an ECG, it clarifies the decision to mobilize all the personnel necessary for the cath lab to be ready to go when the patient arrives."
In the study, specially trained emergency medical technicians transmitted ECG tracings electronically from the scene or in the ambulance to an on-call cardiologists PDA. The cardiologist, on spotting the definitive signs of a heart attack, could then mobilize the catheterization laboratory while the patient was en route to the hospital.
The researchers were studying a specific kind of heart attack known as an ST-segment elevation myocardial infarction. When a cardiologist spots a major elevation of the tracing in the ST portion of an ECG study, there is little question that patient is having a heart attack.
This study was conducted in only one hospital with a single ambulance service and a small number of cardiologists. Duke researchers are currently organizing a 12-site study across the United States in larger and smaller cities with different sized hospitals and ambulance services.
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