Twelve-Lead Electrocardiogram Acquisition With a Patchy-Type Wireless Device in Ambulance Transport: Simulation-Based
Sunyoung Yoon1, Taerim Kim2, Taehwan Roh3
1Department of Digital Health, Samsung Advanced Institute for Health Science & Technology (SAIHST), Sungkyunkwan University, Seoul, Republic of Korea.
Insights
A new patchy-type 12-lead ECG (P-ECG) device significantly speeds up electrocardiogram transmission by emergency medical technicians in ambulances. This time efficiency can lead to quicker patient care for conditions like ST-segment elevation myocardial infarction.
Area of Science:
- Cardiology
- Emergency Medicine
- Medical Device Technology
Background:
- Cardiovascular disease is a leading global cause of mortality.
- Timely diagnosis and treatment, especially reperfusion for ST-segment elevation myocardial infarction (STEMI), are critical.
- Prehospital 12-lead ECG (P12ECG) is recommended but not widely adopted, potentially delaying definitive care.
Purpose of the Study:
- To evaluate the time efficiency and feasibility of a patchy-type 12-lead ECG (P-ECG) device for use by emergency medical technicians (EMTs) during ambulance transport.
- To compare the performance of the P-ECG device against conventional 12-lead ECG (C-ECG) methods.
Main Methods:
- A simulation-based prospective randomized crossover-controlled study involving 18 EMTs.
- Participants used both C-ECG and P-ECG devices in a simulated ambulance environment (30 km/h).
- Time intervals from ECG application to result transmission were measured; usability was assessed via questionnaire.
Main Results:
- The P-ECG device demonstrated significantly faster overall interval times (130 seconds) compared to C-ECG (254 seconds) (P<.001).
- P-ECG was faster in most intervals, with C-ECG being quicker only in the preparation phase (P=.03).
- The P-ECG device showed high usability among EMTs.
Conclusions:
- Prehospital use of the P-ECG device by EMTs is faster than conventional methods during ambulance transport.
- The time saved can allow EMTs to provide additional patient care or expedite transport.
- This improved efficiency may reduce symptom-to-balloon times for acute coronary syndrome patients.
Background:
Cardiovascular disease is the leading cause of death worldwide. Early recognition, diagnosis, and reperfusion are the key elements of treatment for ST-segment elevation myocardial infarction. The absence of a prehospital 12-lead electrocardiogram (P12ECG) can cause definitive treatment delay and repeated transfer. Although guidelines highly recommend the measurement and transmission of P12ECG data, P12ECG use has not been widely established.
Objective:
The aim of this study was to verify the time-efficiency and feasibility of the use of a patchy-type 12-lead ECG measuring and transmitting device (P-ECG) by an emergency medical technician (EMT) in an ambulance during patient transport.
Methods:
This was a simulation-based prospective randomized crossover-controlled study that included EMTs. The participants were randomly assigned to one of two groups. Group A began the experiment with a conventional 12-lead ECG (C-ECG) device and then switched to the intervention device (P-ECG), whereas group B began the experiment with the P-ECG and then switched to the C-ECG. All simulations were performed inside an ambulance driving at 30 km/h. The time interval was measured from the beginning of ECG application to completion of sending the results. After the simulation, participants were administered the System Usability Scale questionnaire about usability of the P-ECG.
Results:
A total of 18 EMTs were recruited for this study with a median age of 35 years. The overall interval time for the C-ECG was 254 seconds (IQR 247-270), whereas the overall interval time for the P-ECG was 130 seconds (IQR 112-150), with a significant difference (P<.001). Significant differences between the C-ECG and P-ECG were identified at all time intervals, in which the P-ECG device was significantly faster in all intervals, except for the preparation interval in which the C-ECG was faster (P=.03).
Conclusions:
Performance of 12-lead ECG examination and transmission of the results using P-ECG are faster than those of C-ECG during ambulance transport. With the additional time afforded, EMTs can provide more care to patients and transport patients more rapidly, which may help reduce the symptoms-to-balloon time for patients with acute coronary syndrome.
Trial Registration:
ClinicalTrials.gov NCT04114760; https://www.clinicaltrials.gov/ct2/show/NCT04114760.
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