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- Title
Transport decisions: acute coronary syndrome and high-risk electrocardiograms.
- Authors
Wyld, Luke
- Abstract
Patients experiencing a high-risk non-ST-elevation myocardial infarction are likely to benefit from prehospital medical contact, transport to a percutaneous coronary intervention (PCI) centre and early definitive treatment. They may be provisionally diagnosed through the identification of a high-risk electrocardiogram (ECG). Advances in ECG interpretation have led to the identification of a cohort of at-risk patients whose treatment may previously have been delayed. Patients with certain ECG changes are considered high risk and may be experiencing coronary occlusions. Early PCI and direct transport to a PCI-capable hospital are associated with a reduction in mortality and morbidity; this is associated with a lower financial burden on the health service. Early paramedic identification of these high-risk ECGs and appropriate transport decision-making can positively influence patient outcomes. High-risk ECGs include those that are positive for the modified Smith-Sgarbossa criteria, DeWinter T waves, Wellens syndrome, posterior acute myocardial infarction and aVR elevation. Continued education is correlated with more accurate ECG interpretation.
- Subjects
PERCUTANEOUS coronary intervention; ACUTE coronary syndrome; TRANSPORTATION of patients; EMERGENCY medical technicians; HOSPITAL costs; TREATMENT delay (Medicine); ELECTROCARDIOGRAPHY; EMERGENCY medical services; DECISION making in clinical medicine; NON-ST elevated myocardial infarction; EARLY medical intervention; EMERGENCY medicine; EARLY diagnosis; ECONOMICS
- Publication
Journal of Paramedic Practice, 2024, Vol 16, Issue 3, p1
- ISSN
1759-1376
- Publication type
Article
- DOI
10.12968/jpar.2024.16.3.CPD1