Emergency cardiac monitoring strategy tested in ambulances

A new UCSF-designed strategy for hastening treatment for heart attack victims is being tested in a mountainous California county where drive times to hospitals are often long. Since August, all ambulances in Santa Cruz County have been equipped with sophisticated cardiac monitors that can send vital data directly by cell phone to the emergency department of the receiving hospital.

"Every minute that heart cells are deprived of blood flow, they are dying," says Barbara Drew, RN, PhD, the study's principal investigator and a professor of physiological nursing in the University of California, San Francisco School of Nursing. "Once heart cells are dead, they don't regenerate. So the initial treatment goal is to get the blockage in the obstructed artery open as quickly as possible before any more heart cells die."

The new "tele-electrocardiography" system consists of an easily-attachable 12-lead cardiac monitor that takes readings every 30 seconds and can detect ischemia, the diminished flow of blood through an artery that signals heart damage. It's hooked to a cell phone that transmits the information directly to the emergency department of the receiving hospital. Based on her years of experience in cardiac intensive care units, Drew came up with the idea to develop such an easily-attachable monitor with ischemia detection capabilities and to use it in ambulances in conjunction with a cell phone.

"Usually when patients arrive at a hospital, they are evaluated by a triage nurse," Drew says. "If their condition warrants it, they are attached to a cardiac monitor for further evaluation. But all that takes time. What we wanted to do was to move the clinical decision-making to a point before the patient even gets to the hospital."

The standard heart monitoring procedure used by medics responding to calls from people experiencing heart attack symptoms involves attaching a cardiac monitor with a single recording lead to the patient'

Contact: Liese Greensfelder
University of California - San Francisco

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