Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Sep 5, 2020
Date Accepted: Mar 11, 2021
12-Lead Electrocardiogram Acquisition with a Patchy-Type Wireless Device in Ambulance Transport: Simulation-Based Randomized Controlled Trial
ABSTRACT
Background:
Cardiovascular disease is the leading cause of death worldwide. Early recognition, early diagnosis, and early 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 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: groups A and B. Group A began the experiment with a conventional 12-lead ECG (C-ECG) device and then switched to an intervention device (a patchy-type wireless 12-lead ECG [P-ECG]), and group B began the experiment with a P-ECG and then switched to a conventional 12-lead ECG (C-ECG). All simulations were conducted inside an ambulance driving at 30 km/h. The time interval was measured from the beginning of the ECG application to the completion of sending the results. After the simulation, participants were administered the System Usability Scale about the usability of the P-ECG.
Results:
A total of 18 EMTs were recruited in this study, and the median age was 35 years. The overall interval time for the C-ECG was 254 s (interquartile range 247-270), whereas the overall interval time for the P-ECG was 130 s (interquartile range, 112-150), with significant differences (P<.001). Significant differences between the C-ECG and P-ECG were identified at all time intervals, and for all intervals except the preparation interval, the P-ECG device was found to be significantly faster. In the preparation interval, the C-ECG was found to be faster than the P-ECG (P=.03).
Conclusions:
Performance of 12-lead ECG examination and transmission of the results using P-ECG is faster than that of C-ECG during ambulance transport. With additional time, EMTs can provide more care to patients and transport patients more rapidly, which may help reduce the symptoms-to-balloon time for acute coronary syndrome patients. Clinical Trial: This study was approved by the Samsung Medical Center Institutional Review Board (No. 2019-04-004) and registered at ClinicalTrials.gov (NCT04114760).
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