Significance of Prehospital 12-Lead Electrocardiogram Transmission　- Trial Utilizing an Established Smartphone...

The Japanese Resuscitation Council's 2020 Guidelines recommend transmitting a prehospital 12-lead electrocardiogram (PH-ECG) for adult patients suspected of having ST-elevation myocardial infarction (STEMI). Nationwide, the primary methods of ECG transmission are either prefecture-specific emergency transport systems or cloud-based services. However, prefectural systems often lack convenience, while cloud-based services are associated with substantial implementation costs.

A smartphone application (JOIN^®), which enables ambulance information-sharing with receiving hospital physicians, has been widely adopted across Japan. Leveraging its photo function to transmit ECGs, we initiated prehospital ECG transmission from ambulances without incurring additional costs. Over the past year, the system has been utilized in approximately 20 cases at our hospital. Analysis of transport times by shift period (weekday daytime vs. non-shift hours [weekday nighttime and weekends/holidays]) revealed no significant difference during daytime shifts. However, during non-shift hours, the ECG transmission group demonstrated a tendency for shorter door-to-catheterization laboratory time (25±5.0 vs. 51±18 min).

Obtaining a 12-lead ECG prior to hospital arrival reduces waiting times for catheter-based treatment. When ambulances and receiving hospitals are connected via a smartphone application, the photo function can facilitate prehospital ECG transmission without additional implementation costs. This approach may represent a novel strategy to improve outcomes for STEMI patients.