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Evidence summaries

Prehospital 12-Lead Electrocardiography with Advanced Notification of Emergency Department in Acute Myocardial Infarction

Prehospital ECG with advanced notification of emergency department (ED) may reduce time to treatment from arrival in the ED. Level of evidence: "C"

A systematic review 1 including 5 studies was abstracted in DARE. There was one randomised controlled trial, three non-randomised controlled studies with a concurrent control group, and one non-randomised controlled study with an historical control group. The total number of participants was unclear. The studies were generally of a poor quality. There was no statistically significant difference between intervention and control for the on-scene time interval (3 studies; WMD 1.19 minutes, 95% CI: -0.84, 3.21). The time to treatment from arrival in the emergency department was shorter in the intervention group than in the standard care control group (3 studies; WMD 36.1 minutes, 95% CI: -63.0, -9.27). There was statistically significant heterogeneity. There was no statistically significant difference in mortality between the group receiving prehospital ECG and advance hospital notification and those receiving standard care (8.4% and 15.6% mortality, respectively; P=0.22).

Comment: The quality of evidence is downgraded by study quality (several limitations).

    References

    • Morrison LJ, Brooks S, Sawadsky B, McDonald A, Verbeek PR. Prehospital 12-lead electrocardiography impact on acute myocardial infarction treatment times and mortality: a systematic review. Academic Emergency Medicine 2006;13:84-89. [DARE]

Primary/Secondary Keywords