scholarly journals 12-Lead Electrocardiogram Acquisition with a Patchy-Type Wireless Device During Ambulance Transport (Preprint)

2020 ◽  
Author(s):  
Sunyoung Yoon ◽  
Tae Rim Kim ◽  
Taehwan Roh ◽  
Han Sol Chang ◽  
Sung Yeon Hwang ◽  
...  
Keyword(s):  
Interquartile Range ◽  
Emergency Medical Technicians ◽  
Definitive Treatment ◽  
Controlled Study ◽  
Patch Type ◽  
Early Reperfusion ◽  
Interval Time ◽  
Emergency Medical ◽  
System Usability Scale ◽  
Conventional Device

BACKGROUND Cardiovascular disease is the leading cause of death worldwide. Early recognition, early diagnosis, and early reperfusion are the key elements of treatment for ST-segment elevation myocardial infarction. Absence of prehospital 12-lead electrocardiogram (P12ECG) can cause definitive treatment delay and repeated transfer. Although guidelines highly recommend the measuring and transmitting of P12ECG data, P12ECG use has not been widely established. OBJECTIVE The aim of this study was to verify the time-efficiency and feasibility of using a patchy-type 12-lead ECG measuring and transmitting device by an emergency medical technician (EMT) in the ambulance during patient transport. METHODS This was a prospective randomized crossover controlled study that was simulation-based and included 119 emergency medical technicians. Participants were randomly assigned to one of two groups. Group A first underwent experiments with a conventional device and then transferred to an intervention device, and group B first underwent experiments with an intervention device and then transferred to a conventional device. All tests were conducted inside an ambulance driving at 30 km/h. The time interval was measured from the beginning of the ECG test application to the completion of sending the results. After the simulation test, participants were administered the System Usability Scale. RESULTS A total of 18 emergency medical technicians were recruited in this study, and the median age was 35 years old. The overall interval time for the conventional device was 254 s (interquartile range 247-270), whereas the overall interval time for the intervention device was 130 s (interquartile range 112-150) for significant differences (P<.001). Significant differences between the conventional device and intervention device were identified in all time intervals, and for all intervals except interval 1, the intervention device was found to be significantly faster. In interval 1, the conventional device was found to be faster than the intervention device (P=.034). CONCLUSIONS The capture and transmission of P12ECG data using patch-type ECG recorders in the transporting ambulance is faster compared with the use of a conventional defibrillator device. This study is registered at ClinicalTrials.gov (NCT04114760). CLINICALTRIAL This study was approved by the Samsung Medical Center Institutional Review Board (No. 2019-04-004) and registered at ClinicalTrials.gov (NCT04114760).

scholarly journals Twelve-Lead Electrocardiogram Acquisition With a Patchy-Type Wireless Device in Ambulance Transport: Simulation-Based Randomized Controlled Trial

10.2196/24142 ◽  
2021 ◽  
Vol 9 (4) ◽  
pp. e24142
Author(s):  
Sunyoung Yoon ◽  
Taerim Kim ◽  
Taehwan Roh ◽  
Hansol Chang ◽  
Sung Yeon Hwang ◽  
...  
Keyword(s):  
Emergency Medical Technician ◽  
Definitive Treatment ◽  
Controlled Study ◽  
Time Interval ◽  
Interval Time ◽  
Coronary Syndrome ◽  
Ambulance Transport ◽  
System Usability Scale ◽  
Significant Difference ◽  
Simulation Based

Background Cardiovascular disease is the leading cause of death worldwide. Early recognition, diagnosis, and reperfusion are the key elements of treatment for ST-segment elevation myocardial infarction. The absence of a prehospital 12-lead electrocardiogram (P12ECG) can cause definitive treatment delay and repeated transfer. Although guidelines highly recommend the measurement and transmission of P12ECG data, P12ECG use has not been widely established. Objective The aim of this study was to verify the time-efficiency and feasibility of the use of a patchy-type 12-lead ECG measuring and transmitting device (P-ECG) by an emergency medical technician (EMT) in an ambulance during patient transport. Methods This was a simulation-based prospective randomized crossover-controlled study that included EMTs. The participants were randomly assigned to one of two groups. Group A began the experiment with a conventional 12-lead ECG (C-ECG) device and then switched to the intervention device (P-ECG), whereas group B began the experiment with the P-ECG and then switched to the C-ECG. All simulations were performed inside an ambulance driving at 30 km/h. The time interval was measured from the beginning of ECG application to completion of sending the results. After the simulation, participants were administered the System Usability Scale questionnaire about usability of the P-ECG. Results A total of 18 EMTs were recruited for this study with a median age of 35 years. The overall interval time for the C-ECG was 254 seconds (IQR 247-270), whereas the overall interval time for the P-ECG was 130 seconds (IQR 112-150), with a significant difference (P<.001). Significant differences between the C-ECG and P-ECG were identified at all time intervals, in which the P-ECG device was significantly faster in all intervals, except for the preparation interval in which the C-ECG was faster (P=.03). Conclusions Performance of 12-lead ECG examination and transmission of the results using P-ECG are faster than those of C-ECG during ambulance transport. With the additional time afforded, EMTs can provide more care to patients and transport patients more rapidly, which may help reduce the symptoms-to-balloon time for patients with acute coronary syndrome. Trial Registration ClinicalTrials.gov NCT04114760; https://www.clinicaltrials.gov/ct2/show/NCT04114760

scholarly journals Prehospital emergency medical technicians can perform ultrasonography and blood analysis in prehospital evaluation of patients with chronic obstructive pulmonary disease: a feasibility study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Giti Nadim ◽  
Christian B. Laursen ◽  
Pia I. Pietersen ◽  
Daniel Wittrock ◽  
Michael K. Sørensen ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Respiratory Insufficiency ◽  
Emergency Departments ◽  
Emergency Medical Technicians ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Emergency Medical ◽  
Short Period ◽  
Release Strategy

Abstract Introduction Crowding of the emergency departments is an increasing problem. Many patients with an exacerbation of chronic obstructive pulmonary disease (COPD) are often treated in the emergency departments for a very short period before discharged to their homes. It is possible that this treatment could take place in the patients’ homes with sufficient diagnostics supporting the treatment. In an effort to keep the diagnostics and treatment of some of these patients in their homes and thus to reduce the patient load at the emergency departments, we implemented a prehospital treat-and-release strategy based on ultrasonography and blood testing performed by emergency medical technicians (EMT) or paramedics (PM) in patients with acute exacerbation of COPD. Method EMTs and PMs were enrolled in a six-hour educational program covering ultrasonography of the lungs and point of care blood tests. During the seasonal peak of COPD exacerbations (October 2018 – May 2019) all patients who were treated by the ambulance crews for respiratory insufficiency were screened in the ambulances. If the patient had uncomplicated COPD not requiring immediate transport to the hospital, ultrasonographic examination of the lungs, measurements of C-reactive protein and venous blood gases analyses were performed. The response to the initial treatment and the results obtained were discussed via telemedical consultation with a prehospital anaesthesiologist who then decided to either release the patient at the scene or to have the patient transported to the hospital. The primary outcome was strategy feasibility. Results We included 100 EMTs and PMs in the study. During the study period, 771 patients with respiratory insufficiency were screened. Uncomplicated COPD was rare as only 41patients were treated according to the treat-and-release strategy. Twenty of these patients (49%) were released at the scene. In further ten patients, technical problems were encountered hindering release at the scene. Conclusion In a few selected patients with suspected acute exacerbations of COPD, it was technically and organisationally feasible for EMTs and PMs to perform prehospital POCT-ultrasound and laboratory testing and release the patients following treatment. None of the patients released at the scene requested a secondary ambulance within the first 48 h following the intervention.

scholarly journals Impact of a Smart-Ring-Based Feedback System on the Quality of Chest Compressions in Adult Cardiac Arrest: A Randomized Preliminary Study

2021 ◽  
Vol 18 (10) ◽  
pp. 5408
Author(s):  
Chiwon Ahn ◽  
Seungjae Lee ◽  
Jongshill Lee ◽  
Jaehoon Oh ◽  
Yeongtak Song ◽  
...  
Keyword(s):  
Primary Outcome ◽  
Feedback System ◽  
Controlled Study ◽  
Feedback Group ◽  
Compression Depth ◽  
System Usability Scale ◽  
The Mean ◽  
Preliminary Study ◽  
The Ideal

This study aimed to assess the effectiveness of a novel chest compression (CC) smart-ring-based feedback system in a manikin simulation. In this randomized, crossover, controlled study, we evaluated the effect of smart-ring CC feedback on cardiopulmonary resuscitation (CPR). The learnability and usability of the tool were evaluated with the System Usability Scale (SUS). Participants were divided into two groups and each performed CCs with and without feedback 2 weeks apart, using different orders. The primary outcome was compression depth; the proportion of accurate-depth (5–6 cm) CCs, CC rate, and the proportion of complete CCs (≤1 cm of residual leaning) were assessed additionally. The feedback group and the non-feedback group showed significant differences in compression depth (52.1 (46.3–54.8) vs. 47.1 (40.5–49.9) mm, p = 0.021). The proportion of accurate-depth CCs was significantly higher in the interventional than in the control condition (88.7 (30.0–99.1) vs. 22.6 (0.0–58.5%), p = 0.033). The mean SUS score was 83.9 ± 8.7 points. The acceptability ranges were ‘acceptable’, and the adjective rating was ‘excellent’. CCs with smart-ring feedback could help achieve the ideal range of depth during CPR. The smart-ring may be a valuable source of CPR feedback.

Abstract 354: A Prediction Model for Patients With Emergency Medical Technicians Witnessed Out-of-Hospital Cardiac Arrest

Circulation ◽  
2018 ◽  
Vol 138 (Suppl_2) ◽  
Author(s):  
Ming-Ju Hsieh ◽  
Wen-Chu Chiang ◽  
Wei-Tien Chang ◽  
Chih-Wei Yang ◽  
Yu-Chun Chien ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Prediction Model ◽  
Situation Awareness ◽  
Blood Pressure Level ◽  
Emergency Medical Technicians ◽  
Validation Dataset ◽  
Systolic Blood Pressure Level ◽  
Value System ◽  
Emergency Medical ◽  
Hospital Cardiac Arrest

Introduction: In-hospital early warning system scores for prediction of clinical deterioration have been well-developed. However, such prediction tools in prehospital setting remain unavailable. Hypothesis: To develop a model for predicting patients with emergency medical technicians witnessed out-of-hospital cardiac arrest (EMT-witnessed OHCA) . Methods: We used the fire-based emergency medical service (EMS) data from Taipei city to develop the prediction model. Patients included in this study were those initially alive, non-traumatic, and aged ≧20 years. Data were extracted from records of ambulance run sheets and OHCA registry in Taipei. The primary outcome (i.e. EMT-witnessed OHCA) was defined as cardiac arrest occurring during EMT services before arrival at the receiving hospital. The prediction model was developed through the standard cross-validation method (i.e. divided dataset for training group and validation group). Area under the receiver operating characteristic curve (AUC) and Hosmer-Lemeshow (HL) test were used to test discrimination and calibration. The point value system with Youden’s J Index was used to find the best cut-off value for practical application. Results: From 2011 to 2015, a total of 252,771 patients were included. Of them, 660 (0.26%) were EMT-witnessed OHCA. The prediction model, including gender, respiratory rate, heart rate, systolic blood pressure, level of consciousness and oxygen saturation, showed excellent discrimination (AUC 0.94) and calibration ( p =0.42 for HL test). When applied to the validation dataset, it maintained good discriminatory ability (AUC 0.94) and calibration ( p =0.11). The optimal cut-off value (≧13) of the point value system of the tool showed high sensitivity (87.84%) and specificity (86.20%). Conclusions: The newly developed prediction model will help identify high-risk patients with EMT-witnessed OHCA and indicate potential prevention by situation awareness in EMS.

scholarly journals The validation of the Maslach Burnout Inventory – Human services survey for emergency medical technicians in Gauteng

2004 ◽  
Vol 30 (3) ◽  
Author(s):  
J. L. P. Naudé ◽  
S. Rothmann
Keyword(s):  
Human Services ◽  
Factor Model ◽  
Survey Design ◽  
Maslach Burnout Inventory ◽  
Personal Accomplishment ◽  
Emergency Medical Technicians ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Emergency Medical ◽  
Construct Equivalence

The objectives of this study were to validate the Maslach Burnout Inventory – Human Services Survey (MBI-HSS) for emergency medical technicians in the Gauteng Province of South Africa and to determine its construct equivalence and bias for different race groups. A cross-sectional survey design with an accidental sample (N = 318) was used. The MBIHSS and a biographical questionnaire were administered. Evidence of uniform bias was found for one item of the MBIHSS. Exploratory factor analyses resulted in a 3-factor model of burnout, consisting of Emotional Exhaustion, Depersonalisation and Personal Accomplishment. The scales showed acceptable internal consistencies. Exploratory factor analysis with target rotations confirmed construct equivalence of scales for the White and Black groups. Opsomming Die doelstellings van hierdie studie was om die Maslach Uitbrandingsvraelys – Menslike Dienste-Opname (MBI-HSS) te valideer vir die Nood Mediese Tegnici in die Gauteng Provinsie van Suid-Afrika en om die konstrukekwivalensie en sydigheid daarvan vir die verskillende rassegroepe te bepaal. ’n Dwarssnee opname-ontwerp met ’n beskikbaarheidsteekproef (N = 318) is gebruik. Die MBI-HSS en ’n biografiese vraelys is afgeneem. Uniforme sydigheid is gevind vir een item van die MBI-HSS. Verkennende faktorontleding met teikenrotasies het geresulteer in ’n 3-faktormodel van uitbranding bestaande uit Emosionele Uitputting, Depersonalisasie en Persoonlike Bereiking. Die skale het aanvaarbare interne konsekwentheid getoon. Verkennende faktorontleding met teikenrotasies het die konstrukekwivalensie vir die drie faktore bevestig vir die Wit en Swart groepe.

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