ECG Training for EMS, Lowers Heart Attack Fatalities

(EMS), to read electrocardiograms so that they can thoroughly evaluate patients with chest pain. Furthermore, they can expedite the treatment for patients with severe heart conditions, specifically ST-segment elevation myocardial infractions (STEMI). According to two studies in the current issue of The Canadian Journal of Cardiology, the process has positive results.

"It's well established that morbidity and mortality in myocardial infarctions is directly related to the duration of ischemia, and delays in restoring the flow of blood to the heart of even 30 minutes have been associated with an increase in mortality," says lead investigator Robin A. Ducas, MD, of the University of Manitoba, Winnipeg, Canada. "By training EMS to administer and interpret ECGs at the scene, with oversight from an on-call physician, we demonstrated that we could achieve benchmark times from first medical contact to treatment."

A study of Manitoban hospitals, conducted in 2005, revealed that only 14% of patients were given thrombolysis (drugs to dissolve blood clots) within 30 minutes of their first medical contact, and only 11% recieved angioplasty within 90 minutes of their first medical contact. In reaction to the problem, a system of pre-hospital ECG interpretation was implemented. EMS receive specific training in the administration and interpretation of ECG's and for signs of STEMI. When STEMI is discovered, findings are transmitted to the hand-held device of an on-call physician for confirmation. Pre-hospital thromobolysis (PHL) is given to the patients and hospitals are alerted.

"The adoption of similar strategies in other urban areas could allow for achievement of guideline times, particularly for PPCI and regardless of the time of day," says Dr. Ducas. "Transfer of patients with suspicious but negative ECG for STEMI (PHENST) to hospitals with comprehensive cardiac care may be warranted, and deserves further consideration."

For more information on how the studies were conducted, visit: