Frequency of non-ST-segment elevation injury patterns on prehospital electrocardiograms

Prehospital Emergency Care : Official Journal of the National Association of EMS Physicians and the National Association of State EMS Directors
Samuel D TurnipseedDeborah B Diercks

Abstract

Prehospital electrocardiograms (ECGs) have been recommended to facilitate early diagnosis of ST-segment elevation myocardial infarction (STEMI). However, prehospital ECGs can also be used to triage patients with non-ST-segment elevation acute coronary syndromes, who comprise a majority of patients with ischemic events presenting by ambulance to overcrowded emergency departments. We assessed the frequency of non-ST-segment elevation injury patterns on prehospital ECGs in patients with a chief complaint of chest pain evaluated by the emergency medical services (EMS) system. We analyzed prehospital ECGs of patients with the chief complaint of chest pain during a nine-month period. The ECGs were divided into three categories: injury pattern; no injury pattern; and technically uninterpretable. Injury pattern criteria were as follows: 1) regional ST depression >or=1.0 mm; 2) regional T-wave inversion (TWI) >or=3 mm; 3) left bundle branch block (LBBB); and 4) regional ST-segment elevation >or=1.0 mm. Descriptive statistics with 95% confidence intervals (CIs) are presented. Prehospital ECGs were obtained for 322 of 340 chest pain patients: 72% were men; the average age was 60 years (range 18-96 years). Seventy-seven ECGs (24%, 95% CI 1...Continue Reading

References

May 2, 1985·The New England Journal of Medicine·J E BrushF J Wackers
Mar 15, 1994·The American Journal of Cardiology·S W SharkeyT D Henry
Apr 20, 2000·The New England Journal of Medicine·T H Lee, L Goldman
Jun 16, 2000·The Western Journal of Medicine·J R RichardsR W Derlet
Feb 7, 2001·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·R DerletR Kravitz
Jan 5, 2002·Emergency Medicine Journal : EMJ·M WhitbreadT J Coats
Apr 3, 2003·The American Journal of Emergency Medicine·Jeffrey D FergusonTom P Aufderheide
Dec 13, 2005·The American Journal of Emergency Medicine·Deborah B DiercksJudd E Hollander

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Citations

Oct 1, 2011·Prehospital Emergency Care : Official Journal of the National Association of EMS Physicians and the National Association of State EMS Directors·P Richard VerbeekAlan M Craig
Sep 14, 2013·Prehospital Emergency Care : Official Journal of the National Association of EMS Physicians and the National Association of State EMS Directors·Matthew DavisAdam Dukelow
Jan 18, 2018·Prehospital Emergency Care : Official Journal of the National Association of EMS Physicians and the National Association of State EMS Directors·Alain TanguayFrançois Bégin
May 19, 2018·Disability and Rehabilitation. Assistive Technology·Deirdre DesmondMarcia J Scherer
Mar 4, 2011·Prehospital Emergency Care : Official Journal of the National Association of EMS Physicians and the National Association of State EMS Directors·Harry P SelkerJohn L Griffith

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