Pre-Hospital ECG E-Transmission for Patients with Suspected Myocardial Infarction in the Highlands of Scotland

International Journal of Environmental Research and Public Health. 2014;11(2):2346-2360 DOI 10.3390/ijerph110202346

 

Journal Homepage

Journal Title: International Journal of Environmental Research and Public Health

ISSN: 1661-7827 (Print); 1660-4601 (Online)

Publisher: MDPI AG

LCC Subject Category: Medicine

Country of publisher: Switzerland

Language of fulltext: English

Full-text formats available: PDF, HTML, ePUB, XML

 

AUTHORS

Gordon F. Rushworth (Highland Clinical Research Facility, Centre for Health Science, Old Perth Road, Inverness IV2 3JH, UK)
Charlie Bloe (Cardiac Unit, Raigmore Hospital, Old Perth Road, Inverness IV2 3UJ, UK)
H. Lesley Diack (School of Pharmacy and Life Sciences, Robert Gordon University, Riverside East, Garthdee Road, Aberdeen AB10 7GJ, UK)
Rachel Reilly (School of Pharmacy and Life Sciences, Robert Gordon University, Riverside East, Garthdee Road, Aberdeen AB10 7GJ, UK)
Calum Murray (School of Pharmacy and Life Sciences, Robert Gordon University, Riverside East, Garthdee Road, Aberdeen AB10 7GJ, UK)
Derek Stewart (School of Pharmacy and Life Sciences, Robert Gordon University, Riverside East, Garthdee Road, Aberdeen AB10 7GJ, UK)
Stephen J. Leslie (Cardiac Unit, Raigmore Hospital, Old Perth Road, Inverness IV2 3UJ, UK)

EDITORIAL INFORMATION

Blind peer review

Editorial Board

Instructions for authors

Time From Submission to Publication: 11 weeks

 

Abstract | Full Text

Patients with ST elevation myocardial infarction (STEMI) require prompt treatment, best done by primary percutaneous coronary intervention (PPCI). However, for patients unable to receive PPCI, immediate pre-hospital thrombolysis (PHT) is the best alternative. Evidence indicates that diagnostic and management support for staff increases the use of PHT. This study aimed to describe the patient demographics and management of patients, to determine any potential inter-area differences in referral rates to the ECG e-transmission service and to explore the views and experiences of key staff involved in ECG e-transmission within NHS Highland. Data from 2,025 patient episodes of ECG e-transmission identified a statistically significant geographical variation in ECG e-transmission and PHT delivery. Scottish Ambulance Service (SAS) staff were more likely than GPs to deliver PHT overall, however, GPs were more likely to deliver in remote areas. Interviews with six Cardiac Care Unit (CCU) nurses and six SAS staff highlighted their positive views of ECG e-transmission, citing perceived benefits to patients and interprofessional relationships. Poor access to network signal was noted to be a barrier to engaging in the system. This study has demonstrated that a specialist triage service based on e-transmission of ECGs in patients with suspected STEMI can be implemented in a diverse geographical setting. Work is needed to ensure equity of the service for all patients.