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March 11, 2021JMIR mhealth and uhealthOpen Access

Twelve-Lead Electrocardiogram Acquisition With a Patchy-Type Wireless Device in Ambulance Transport: Simulation-Based Randomized Controlled Trial

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Key result

The patchy-type wireless 12-lead ECG device significantly reduced the overall time for ECG acquisition and transmission compared to the conventional device (median 130 vs 254 seconds).

Why the study?

Prehospital 12-lead ECG is recommended for STEMI but not widely established, and the time-efficiency and feasibility of a patchy-type wireless device in an ambulance needed verification.

Does a patchy-type wireless 12-lead ECG device reduce the time required for ECG acquisition and transmission by EMTs during ambulance transport compared to a conventional 12-lead ECG?

Population

18 EMTs

Comparison

Patchy-type 12-lead ECG device vs conventional 12-lead ECG device

Design

Simulation-based prospective randomized crossover-controlled study

Authors

SYSunyoung YoonSamsung (South Korea)TKTaerim KimInje UniversityTRTaehwan RohSeoul National University

Discussion

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Implication

May accelerate prehospital ECG workflows by EMTs; extends RCT evidence for patchy wireless devices in ambulance transport.

Study Design

Type

RCT (n=18)

Randomization

Randomized crossover

Multicenter

No

Structured PICO

Does a patchy-type wireless 12-lead ECG device reduce the time required for ECG acquisition and transmission by EMTs during ambulance transport compared to a conventional 12-lead ECG?

P
Population
18 level-1 certified emergency medical technicians (EMTs) in Seoul, South Korea, median age 35 years, participating in a simulation-based ambulance transport study.
I
Intervention
Patchy-type wireless 12-lead ECG measuring and transmitting device (P-ECG, wearECG12) used during simulated ambulance transport.
C
Comparator
Conventional 12-lead ECG device (C-ECG, ZOLL X series defibrillator) used during simulated ambulance transport.
O
Outcome
Time intervals during each stage (preparation, attachment, acquisition, transmission) and overall interval time from the 'start' command to the acquisition of an ECG image by a remote provider.surrogate

Main Result

Absolute Event Rate: 130% vs 254%

p-value: p=<.001

A patchy-type wireless 12-lead ECG device significantly reduces the time required for prehospital ECG acquisition and transmission by EMTs compared to conventional devices, potentially accelerating STEMI care.

Limitations

  • Simulation-based study with limited driving course and speed (30 km/h)
  • Simulated patient was a healthy adult man, not an actual patient
  • Conducted in a single city (Seoul) with well-implemented LTE/5G networks, which may not generalize to other areas
  • Did not assess the quality and accuracy of the ECG data, only time intervals and usability
  • Only one device was used, limiting generalizability to other prehospital devices
  • Simulation-based study with limited driving speed (30 km/h) and healthy mock patient
  • Conducted in Seoul with well-implemented LTE/5G networks and young participants
  • Only one device used, limiting generalizability to other prehospital devices
  • Did not assess the quality and accuracy of the ECG data
  • Only examined one component of STEMI treatment

Cite This Study

Yoon et al. (2021) conducted an RCT in Prehospital 12-lead ECG acquisition (n=18). Patchy-type wireless 12-lead ECG (P-ECG) vs. Conventional 12-lead ECG (C-ECG) was evaluated on Overall time interval from preparation to transmission completion (seconds) (p=<.001). The patchy-type wireless 12-lead ECG device significantly reduced the overall time for ECG acquisition and transmission compared to the conventional device (median 130 vs 254 seconds).

synapsesocial.com/papers/6a1c03244ebd09f3dfa95561https://doi.org/10.2196/24142
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Lifelink: 3G-Based Mobile Telemedicine System2009 · 18 citations
  2. 2Ambulance 12-Lead Electrocardiography Transmission via Cell Phone Technology to Cardiologists2010 · 23 citations
  3. 3Effects of prehospital 12-lead ECG on processes of care and mortality in acute coronary syndrome: a linked cohort study from the Myocardial Ischaemia National Audit Project2014 · 127 citations
  4. 4ECG pre-hospital teletransmission by emergency teams staffed with an emergency physician and paramedics and its impact on transportation and hospital admission2019 · 9 citations
  5. 5Cellular Video-Phone Assisted Transmission and Interpretation of Prehospital 12-Lead Electrocardiogram in Acute ST-Segment Elevation Myocardial Infarction2011 · 13 citations