(P2-11) Teletransmission of 12-Lead ECG in Warsaw Ambulance Service — Analysis of the First Months of the Operation

Abstract

Background

Since September 2009, the Warsaw Ambulance Service (WAS) has enabled 23 ambulances to carry out a 12-lead electrocardiograph (ECG) transmission to the specialist in the ECG transmission center, and in return received an interpretation of sent data along with guidelines concerning further treatment and transportation. This would allow patients with myocardial infarction (MI) eligible for PCI to be transported directly to the catheterization laboratory. The aim of this study was to present the results of the first four months of operation of the ECG transmission system in WAS, and assess the frequency of its use and the amount of MI it covered. Furthermore this study, attended to the main issues that might have had a negative impact on the surveyed system.

Methods

Since September 2009, each attempt of transmission was described by a number of factors by the staff attending to ECG transmission center. Documentation created from September to December 2009 was subjected to a thorough analysis.

Results

From September to December 2009, there was a total of 1,650 attempts of transmission, 292 (18%) of them were unsuccessful. Of 1,358 successfully transmitted ECGs, 39 (3%) suggested a ST-Segment Elevation Myocardial Infarction (STEMI) and 149 (11%) suggested a Non-ST-Elevation Myocardial Infarction (NSTEMI). The number of attempted ECG transmission carried out by individual ambulance teams per intervention was significantly different (p < 0.001) and showed a relation with a place of stationing. The proportion of unsuccessful attempts was significantly different for individual ambulance teams (p < 0.001) and was higher for ambulance teams with lower amount of attempts (p < 0.0001).

Conclusions

Prehospital 12-Lead ECGs help to reduce emergency medical services-to-Balloon times. It often was used as a support in case of patients without symptoms typical for MI. Motivation and personal opinion of individual ambulance teams about the system affected frequency of its use. More frequent use of the system by ambulance teams resulted in a lower percentage of unsuccessful attempts of ECG transmission.