Building the Infrastructure for the 'EMS-to-Balloon' Era of STEMI Treatment

For a number of years EMS organizations have transported patients suffering acute myocardial infarction with a diagnostic ECG showing ST-segment elevation directly to primary coronary intervention, thus bypassing the emergency department.1 Protocol for activating the cath lab in STEMI patients varies from one organization to another, but the primary methods used are: Utilization of automated ECG/computer interpretation of the ECG ECG transmission to the on-call cardiologist Diagnosis by trained paramedics2 However, few organizations combine all three of these methods. EMS activation of the cath lab has been proven to shorten the time from symptom onset to catheterization by almost 40%.3 Figure 1: Paramedic app screens The MDA Teams app allows the paramedic to call the on-call cardiologist, transmit ECGs and patient vitals securely and directly, all while recording and documenting the event. Magen David Adom (MDA) is the Israeli national EMS organization, which also runs the Israeli Paramedics School. MDA paramedics are well trained in ECG interpretation and are able to identify ST-elevation myocardial infarction. For many years, MDA paramedics have directly activated the cath lab. Before the smartphone era, paramedics used mobile phones to orally describe the patient, symptoms and the ECG, however since smartphones are currently widely used, transmission of the ECG is possible through personal messaging applications such as WhatsApp.
Source: JEMS Administration and Leadership - Category: Emergency Medicine Authors: Tags: Cardiac & Resuscitation Documentation Patient Care Reporting Source Type: news