EKG Transmission is NOT

Necessary!!

Timothy D. Henry, MD

Director of Cardiology

Cedars-Sinai Heart Institute

You’ve got to be very careful if you don’t

know where you are going, because you

might not get there.

Yogi Berra

Key point # 1 :

Get a Pre-Hospital ECG & Activate the STEMI System

• Follow Standardized Protocol

• Pre-hospital ECG • Transmission

3 Options:

• Pre-Hosp ECG Paramedics

Key point # 2:

Guidelines support ED activation not Cardiology!

STEMI Guidelines 3.2: “…there is a significant association between arrival at the ED by

ambulance and earlier delivery of reperfusion therapy.64–66,68 In addition, the

performance of prehospital ECGs by trained personnel is associated with shorter

reperfusion times69 and lower mortality rates from STEMI. The use of prehospital

ECGs, particularly when coupled with communication of STEMI diagnosis and

preferential transport to a PCI-capable hospital, has been shown to result in rapid

reperfusion times and excellent clinical outcomes.70–72”

O’Gara et al. Circ. 2013 p.e369

Cardiologist @ 2 AM

ED Physician @ 2AM

Key point # 3:

Large STEMI Centers with the Best

Outcomes Do Not Use Transmission!!!

Key point # 4:

I support Technologic advances, But Don’t Let It Slow You Down!

• Send the EKG but don’t delay the decision!!

• <10% need review!!!

Key point # 5:

Know your System and your resources!

Lange, Rokos, Henry..Intervent Cardiol Clin 2016

Key point # 6:

No Evidence Transmission Improves Outcomes in LA!

Conclusion: Prehospital ECG transmission

is associated with a small reduction in

false-positive field activations for STEMI. It

had no effect on time to reperfusion in this

cohort.

Humanity’s greatest advances are

not in its discoveries – but in how

those discoveries are applied ...”

Bill Gates, June 7, 2007

Harvard Commencement Address

When complimented for thinking

outside the box:

“I didn’t know there was a box.”

A very special man, Ed Lother 1925-2013