What If We’re Wrong? Prehospital ECG Interpretation

Conclusions After sorting through that huge pile of information, let’s start drawing some conclusions. Here’s the big three I’ve gathered from the above studies. Computers are specific but not very sensitive when it comes to recognizing STEMI. When they say it’s a STEMI it usually is, but they also miss a lot of them. Their performance can be improved by ensuring good-quality tracings with mimimal artifact and no “Data quality precludes interpretation” message, but there is still a ceiling to their abilities. Prehospital providers are more sensitive but often less specific than computerized algorithms. Also, their performance varies greatly from region to region. Emergency physicians are at least as good as prehospital providers (at least in studies) and often significantly more accurate at ECG interpretation. They also initiate less false-positive and cancelled activations. So, if you want optimal numbers, your system should be transmitting 100% of its ECG’s to an emergency physician base station for interpretation and activation. I hope that answers the question we set out to address, and true to our goal from the start, it’s certainly a sobering pill for me, your ECG-obsessed author.     …there are some other considerations to keep in mind though. It is expensive to run that sort of setup unless you work in a large system with an academic center willing to handle the influx of ECG’s. ECG’s canno...
Source: EMS 12-Lead - Category: Cardiology Authors: Tags: What If We're Wrong? Vince DiGiulio Source Type: research