BIOMAT Database Logo BIOMAT Database Logo

Prehospital 12-lead ST-segment monitoring improves the early diagnosis of acute coronary syndrome. 2012

Jessica K Zègre Hemsey, and Kathleen Dracup, and Kirsten Fleischmann, and Claire E Sommargren, and Barbara J Drew
School of Nursing, University of California, San Francisco, CA, USA. Jessica.zegre@nursing.ucsf.edu

OBJECTIVE We studied 620 patients who activated "911" for chest pain symptoms to determine the sensitivity and specificity of 12-lead electrocardiogram (ECG) ST-segment monitoring in the prehospital period (PH ECG) for diagnosing acute coronary syndrome (ACS) and to assess whether the addition of PH ECG signs of ischemia/injury to the initial hospital 12-lead ECG obtained in the emergency department would improve the diagnosis of ACS. RESULTS The sensitivity and specificity of the PH ECG were 65.4% and 66.4%. There was a significant increase in sensitivity (79.9%) and decrease in specificity (61.2%) when considered in conjunction with the initial hospital ECG (P < .001). Those with PH ECG ischemia/injury were more than 2.5 times likely to have an ACS diagnosis than those who had no PH ECG ischemia/injury (P < .001). CONCLUSIONS Prehospital ECG data obtained with 12-lead ST-segment monitoring provides diagnostic information about ACS above and beyond the initial hospital ECG.

UI MeSH Term Description Entries
D008297 Male Males
D011379 Prognosis A prediction of the probable outcome of a disease based on a individual's condition and the usual course of the disease as seen in similar situations. Prognostic Factor,Prognostic Factors,Factor, Prognostic,Factors, Prognostic,Prognoses
D002140 California State bounded on the east by Nevada and Arizona, on the south by Mexico and the Pacific Ocean on the south and west, and on the north by Oregon.
D004562 Electrocardiography Recording of the moment-to-moment electromotive forces of the HEART as projected onto various sites on the body's surface, delineated as a scalar function of time. The recording is monitored by a tracing on slow moving chart paper or by observing it on a cardioscope, which is a CATHODE RAY TUBE DISPLAY. 12-Lead ECG,12-Lead EKG,12-Lead Electrocardiography,Cardiography,ECG,EKG,Electrocardiogram,Electrocardiograph,12 Lead ECG,12 Lead EKG,12 Lead Electrocardiography,12-Lead ECGs,12-Lead EKGs,12-Lead Electrocardiographies,Cardiographies,ECG, 12-Lead,EKG, 12-Lead,Electrocardiograms,Electrocardiographies, 12-Lead,Electrocardiographs,Electrocardiography, 12-Lead
D004632 Emergency Medical Services Services specifically designed, staffed, and equipped for the emergency care of patients. Emergency Care,Emergency Health Services,Emergicenters,Prehospital Emergency Care,Emergency Care, Prehospital,Emergency Services, Medical,Medical Services, Emergency,Services, Emergency Medical,Emergency Health Service,Emergency Medical Service,Emergency Service, Medical,Emergicenter,Health Service, Emergency,Health Services, Emergency,Medical Emergency Service,Medical Emergency Services,Medical Service, Emergency,Service, Emergency Health,Service, Emergency Medical,Service, Medical Emergency,Services, Emergency Health,Services, Medical Emergency
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D012680 Sensitivity and Specificity Binary classification measures to assess test results. Sensitivity or recall rate is the proportion of true positives. Specificity is the probability of correctly determining the absence of a condition. (From Last, Dictionary of Epidemiology, 2d ed) Specificity,Sensitivity,Specificity and Sensitivity
D015203 Reproducibility of Results The statistical reproducibility of measurements (often in a clinical context), including the testing of instrumentation or techniques to obtain reproducible results. The concept includes reproducibility of physiological measurements, which may be used to develop rules to assess probability or prognosis, or response to a stimulus; reproducibility of occurrence of a condition; and reproducibility of experimental results. Reliability and Validity,Reliability of Result,Reproducibility Of Result,Reproducibility of Finding,Validity of Result,Validity of Results,Face Validity,Reliability (Epidemiology),Reliability of Results,Reproducibility of Findings,Test-Retest Reliability,Validity (Epidemiology),Finding Reproducibilities,Finding Reproducibility,Of Result, Reproducibility,Of Results, Reproducibility,Reliabilities, Test-Retest,Reliability, Test-Retest,Result Reliabilities,Result Reliability,Result Validities,Result Validity,Result, Reproducibility Of,Results, Reproducibility Of,Test Retest Reliability,Validity and Reliability,Validity, Face

Related Publications

Jessica K Zègre Hemsey, and Kathleen Dracup, and Kirsten Fleischmann, and Claire E Sommargren, and Barbara J Drew
Acute coronary syndrome ST-segment monitoring.
November 2014, American journal of critical care : an official publication, American Association of Critical-Care Nurses,
Jessica K Zègre Hemsey, and Kathleen Dracup, and Kirsten Fleischmann, and Claire E Sommargren, and Barbara J Drew
Designing prehospital ECG systems for acute coronary syndromes. Lessons learned from clinical trials involving 12-lead ST-segment monitoring.
October 2005, Journal of electrocardiology,
Jessica K Zègre Hemsey, and Kathleen Dracup, and Kirsten Fleischmann, and Claire E Sommargren, and Barbara J Drew
Management of prehospital thrombolytic therapy in ST-segment elevation acute coronary syndrome (<12 hours).
June 2005, Minerva anestesiologica,
Jessica K Zègre Hemsey, and Kathleen Dracup, and Kirsten Fleischmann, and Claire E Sommargren, and Barbara J Drew
Acute Coronary Syndrome and ST Segment Monitoring.
September 2016, Critical care nursing clinics of North America,
Jessica K Zègre Hemsey, and Kathleen Dracup, and Kirsten Fleischmann, and Claire E Sommargren, and Barbara J Drew
12-lead ST-segment monitoring vs single-lead maximum ST-segment monitoring for detecting ongoing ischemia in patients with unstable coronary syndromes.
September 1998, American journal of critical care : an official publication, American Association of Critical-Care Nurses,
Jessica K Zègre Hemsey, and Kathleen Dracup, and Kirsten Fleischmann, and Claire E Sommargren, and Barbara J Drew
Prehospital diagnosis of ST-segment elevation myocardial infarction using an "all-posterior" 12-lead electrocardiogram.
January 2011, Prehospital emergency care,
Jessica K Zègre Hemsey, and Kathleen Dracup, and Kirsten Fleischmann, and Claire E Sommargren, and Barbara J Drew
Improving use of prehospital 12-lead ECG for early identification and treatment of acute coronary syndrome and ST-elevation myocardial infarction.
May 2010, Circulation. Cardiovascular quality and outcomes,
Jessica K Zègre Hemsey, and Kathleen Dracup, and Kirsten Fleischmann, and Claire E Sommargren, and Barbara J Drew
Significance of lead aVR ST segment elevation in acute coronary syndrome.
October 2005, Journal of the Medical Association of Thailand = Chotmaihet thangphaet,
Jessica K Zègre Hemsey, and Kathleen Dracup, and Kirsten Fleischmann, and Claire E Sommargren, and Barbara J Drew
[ST-segment elevation acute coronary syndromes: Prehospital management strategies].
December 2010, Annales de cardiologie et d'angeiologie,
Jessica K Zègre Hemsey, and Kathleen Dracup, and Kirsten Fleischmann, and Claire E Sommargren, and Barbara J Drew
Serial prehospital 12-lead electrocardiograms increase identification of ST-segment elevation myocardial infarction.
January 2012, Prehospital emergency care,
Copied contents to your clipboard!