Standard 12-lead electrocardiogram tele-transmission: Support in diagnosing cardiovascular diseases in operations undertaken by Warsaw-area basic medical rescue teams between 2009 and 2013

Abstract

Background: Basic medical rescue teams (BMRTs) administer aid in the pre-hospital phase to people in a life-threatening condition. A tele-transmission and teleconsultation system (TTaTC) supports the team without a physician. The aim of the presented study was to evaluate the application and spectrum of use of a 12-lead ECG TTaTC in BMRT operations.

Methods: Medical records of BMRTs in Warsaw from September 2009 to August 2013 regarding TTaTC were checked. Successful TTaTC, electrocardiography (ECG) results, sex, age, consultant advice, and decisions of BMRT leaders were analyzed.

Results: BMRTs performed 28,557 12-lead ECG transmissions within the analyzed period. The teams recorded 26,208 (91.8%) successful tele-transmissions, while 2,349 tests (8.2%) failed to reach the TC. The average TTaTC time was 6 min 12 s. The most common reason for using the ECG TTaTC was chest pain. ST-segment elevation myocardial infarction (STEMI) was diagnosed in 2.1% of the cases, and non-ST segment elevation myocardial infarction — NSTEMI — in 3.8%. Cardiac arrhythmia was recorded in 20.5% of the events. TTaTC proved to be useful when making decisions on transporting patients to appropriate hospitals. One hundred percent of STEMI cases — all confirmed by TC — were transported directly to cardiac centers.

Conclusions: 1. TTaTC constitutes an increasing support in BMRT everyday operations and is widely used. 2. Standard ECG TTaTC with a physician improved BMRT diagnostic capaci­ties and exerted a beneficial impact on cardiovascular patient segregation and target hospital selection. 3. It seems possible to expand the scope of operations performed by BMRT members based on TTaTC.