Please use this identifier to cite or link to this item: https://doi.org/10.1016/j.annemergmed.2012.08.020
Title: Nationwide improvement of door-to-balloon times in patients with acute st-segment elevation myocardial infarction requiring primary percutaneous coronary intervention with out-of-hospital 12-lead ecg recording and transmission
Authors: Ong, M.E.H. 
Wong, A.S.L.
Seet, C.M.
Teo, S.G.
Lim, B.L.
Ong, P.J.L.
Lai, S.M.
Ong, S.H.
Lee, F.C.Y.
Chan, K.P.
Anantharaman, V.
Chua, T.S.J.
Pek, P.P.
Li, H.
Issue Date: Mar-2013
Citation: Ong, M.E.H., Wong, A.S.L., Seet, C.M., Teo, S.G., Lim, B.L., Ong, P.J.L., Lai, S.M., Ong, S.H., Lee, F.C.Y., Chan, K.P., Anantharaman, V., Chua, T.S.J., Pek, P.P., Li, H. (2013-03). Nationwide improvement of door-to-balloon times in patients with acute st-segment elevation myocardial infarction requiring primary percutaneous coronary intervention with out-of-hospital 12-lead ecg recording and transmission. Annals of Emergency Medicine 61 (3) : 339-347. ScholarBank@NUS Repository. https://doi.org/10.1016/j.annemergmed.2012.08.020
Abstract: Study objective: Reducing door-to-balloon times for acute ST-segment elevation myocardial infarction (STEMI) patients has been shown to improve long-term survival. We aim to reduce door-to-balloon time for STEMI patients requiring primary percutaneous coronary intervention by adoption of out-of-hospital 12-lead ECG transmission by Singapore's national ambulance service. Methods: This was a nationwide, before-after study of STEMI patients who presented to the emergency departments (ED) and required percutaneous coronary intervention. In the before phase, chest pain patients received 12-lead ECGs in the ED. In the after phase, 12-lead ECGs were performed by ambulance crews and transmitted from the field to the ED. Patients whose ECG showed greater than or equal to 2 mm ST-segment elevation in anterior or greater than or equal to 1 mm ST-segment elevation in inferior leads for 2 or more contiguous leads and symptom onset of less than 12 hours' duration were eligible for percutaneous coronary intervention activation before arrival. Results: ECGs (2,653) were transmitted by the ambulance service; 180 (7%) were suspected STEMI. One hundred twenty-seven patients from the before and 156 from the after phase met inclusion criteria for analysis. Median door-to-balloon time was 75 minutes in the before and 51 minutes in the after phase (median difference23 minutes; 95% confidence interval 18 to 27 minutes). Median door-to-balloon times were significantly reduced regardless of presentation hours. Overall, there was significant reduction in door-toactivation, door-to-ECG, and door-to- cardiovascular laboratory times. No significant difference was found pertaining to adverse events. Conclusion: This study describes a nationwide implementation of out-of-hospital ECG transmission resulting in reduced door-to-balloon times, regardless of presentation hours. Out-of-hospital ECG transmission should be adopted as best practice for management of chest pain. Copyright © 2012 by the American College of Emergency Physicians.
Source Title: Annals of Emergency Medicine
URI: http://scholarbank.nus.edu.sg/handle/10635/126522
ISSN: 01960644
DOI: 10.1016/j.annemergmed.2012.08.020
Appears in Collections:Staff Publications

Show full item record
Files in This Item:
There are no files associated with this item.

SCOPUSTM   
Citations

17
checked on Sep 19, 2018

WEB OF SCIENCETM
Citations

19
checked on Sep 5, 2018

Page view(s)

22
checked on Aug 16, 2018

Google ScholarTM

Check

Altmetric


Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.