Community-Based Pre-Hospital Electrocardiogram Transmission Program for Reducing Systemic Time Delay in Acute
Kyungil Park1,2, Jong Sung Park1,2, Young Rak Cho1,2
1Department of Cardiology, Dong-A University Hospital, Dong-A University College of Medicine, Busan, Korea.
Korean Circulation Journal
|July 30, 2020
Summary
Implementing a pre-hospital electrocardiogram (ECG) transmission program significantly reduced time delays for ST-segment elevation myocardial infarction (STEMI) patients. This crucial intervention improves emergency cardiac care by enabling faster reperfusion therapy.
Area of Science:
- Cardiology
- Emergency Medicine
- Public Health
Background:
- Acute ST-segment elevation myocardial infarction (STEMI) requires rapid reperfusion.
- Pre-hospital electrocardiogram (ECG) transmission is known to reduce delays but is not widely adopted in Korea's community emergency medical services.
- A joint initiative aimed to implement and evaluate such a program.
Purpose of the Study:
- To develop and implement a community-based pre-hospital ECG transmission program for STEMI patients.
- To assess the impact of this program on systemic time delay to reperfusion.
- To compare door-to-balloon times before and after program implementation.
Main Methods:
- A pre-hospital ECG transmission program was jointly developed by the Busan Regional Cardio-cerebrovascular Center and the Busan Metropolitan City Fire and Safety Headquarters.
- Seven tertiary hospitals and 22 safety stations participated in the program.
- Systemic time delay and door-to-balloon times were compared to historical data from patients transported via the 119 emergency medical system prior to the program.
Main Results:
- 289 ECG transmissions were performed, with 88.1% completed within 5 minutes.
- 42 ECGs showed ST-segment elevation, leading to STEMI diagnosis in 20 patients who received primary percutaneous coronary intervention.
- The program significantly reduced systemic time delay (76.0 vs. 90.0 minutes, p<0.01) and door-to-balloon time (45.0 vs. 58.0 minutes, p=0.03).
Conclusions:
- A community-based pre-hospital ECG transmission program was successfully developed and implemented.
- The program led to significant reductions in systemic time delay and door-to-balloon time for STEMI patients.
- Expanded use of pre-hospital ECG transmission is recommended to optimize STEMI care and patient outcomes.
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