Summary
Full title: Use and impact of the pre-hospital 12-lead electrocardiogram in the primary PCI era. Mixed method study (PHECG-2)
Guidelines for management of patients with suspected acute coronary syndrome (ACS) recommend recording a prehospital 12-lead electrocardiogram (PHECG) to aid diagnosis and decision making, for example about direct transfer to a cardiac catheter laboratory in patients with ST-segment elevation.
Previous research undertaken by our research team has demonstrated an association between PHECG and improved outcomes for ACS patients. But we also found that around a third of patients with an ACS diagnosis who came by ambulance did not have a PHECG recorded. These patients were more likely to be female, elderly and/or have complex health status, and had worse outcomes than those who had PHECG.
Our previous study was undertaken several years ago, when thrombolytic therapy was the main treatment for STEMI. Since then, there has been a rapid shift to using primary percutaneous coronary intervention (pPCI) to treat STEMI patients. Because of this change, we are looking in the new study at a group of patients treated more recently. We will also be exploring in more detail the factors that may influence whether or not a patient receives a PHECG following a call to the ambulance service. The new study has different elements, the first two of which will look at routinely collected data from the Myocardial Ischaemia National Audit Project (MINAP) and from patient records in three ambulance services.
Findings from this study will help us to understand barriers and facilitators to PHECG use by ambulance services, and in due course will inform development of interventions to be tested to help improve patient care.
Contact Details
Trial Manager / Lead Contact: Lucia Gavalova
Email: PHECG2study@sgul.kingston.ac.uk
IRAS ID: 248748;