Ikkelægeledsaget transport af patienter til primaer perkutan koronarintervention. Præhospital anvendelse af telemedicinsk elektrokardiogram og risikostratificering

Translated title of the contribution: Direct referral of patients with ST-elevation acute myocardial infarction to primary percutaneous coronary intervention. Pre-hospital use of telemedicine and risk stratification

Hans Henrik Jepsen, Kenneth Egstrup

Research output: Contribution to journalJournal articleResearchpeer-review

Abstract

INTRODUCTION: Primary percutaneous coronary intervention (PCI) is recommended for revascularisation of patients with ST-elevation acute myocardial infarction (STEMI) with a duration of symptoms less than 12 hours. Primary PCI is recommended even if the patient is to be transported from a non-invasive hospital to an invasive centre. Normally this transport requires an attending physician. This transport strategy is associated with an increased treatment delay. The aim of this study was to assess pre-hospital tele-transmitted electrocardiogram (tele-ECG) and risk stratification by using a questionnaire in order to assess if selected patients with STEMI can be transported safely to primary PCI without an attending physician. MATERIALS AND METHODS: Since January 2005 Fyn Svendborg Hospital has received pre-hospital tele-ECG recorded in patients with suspected acute coronary syndrome (ACS) with simultaneous risk stratification by using a questionnaire. Transportable STEMI patients were referred directly to an invasive centre without an attending physician. RESULTS: During a period of 17 months tele-ECGs were recorded from 1,148 patients. 82 patients had STEMI and 71 patients were transported to an invasive centre without an attending physician. In this group, 1 case of resuscitated ventricular fibrillation was reported. 11 patients were transported to the nearest hospital: 2 to invasive centres, 7 patients were inter-hospital transported with a physician, and transport was not relevant/possible for 2 patients. CONCLUSION: Pre-hospital tele-ECG and risk stratification can select patients with STEMI and transport them safely to an invasive PCI centre without an attending physician.
Translated title of the contributionDirect referral of patients with ST-elevation acute myocardial infarction to primary percutaneous coronary intervention. Pre-hospital use of telemedicine and risk stratification
Original languageDanish
JournalUgeskrift for læger
Volume169
Issue number47
Pages (from-to)4043-4047
Number of pages4
ISSN0041-5782
Publication statusPublished - 19. Nov 2007

Keywords

  • Adult
  • Aged
  • Aged, 80 and over
  • Angioplasty, Transluminal, Percutaneous Coronary
  • Cardiology Service, Hospital
  • Cardiopulmonary Resuscitation
  • Denmark
  • Electrocardiography
  • Emergency Medical Services
  • Female
  • Humans
  • Male
  • Middle Aged
  • Myocardial Infarction
  • Patient Selection
  • Questionnaires
  • Referral and Consultation
  • Risk Assessment
  • Telemedicine
  • Transportation of Patients

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