Key result
Certified paramedic evaluation linked to ~115% higher prehospital ECG use for chest pain vs nonparamedics.
Why the study?
Prehospital 12-lead ECG use for patients with chest pain remains inconsistent, and factors associated with failure to perform ECGs across a statewide geography were not well characterized.
Does paramedic certification improve prehospital 12-lead ECG utilization in patients >30 years of age with chest pain?
Observational (n=134,350)
Yes
Does paramedic certification improve prehospital 12-lead ECG utilization in patients >30 years of age with chest pain?
Relative Risk: 2.15 (95% CI 1.55–2.99)
Prehospital 12-lead ECG use for chest pain increased significantly over time but remains underutilized, with paramedic certification and equipment availability being the strongest predictors of use.
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Statewide factors linked to missed prehospital ECGs may inform targeted EMS interventions; leaves open effects on STEMI outcomes.
Bush et al. (2013) conducted an observational in Chest pain (n=134,350). Evaluation by a certified paramedic vs. Evaluation by nonparamedics (basic/intermediate) was evaluated on Prehospital ECG utilization (RR 2.15, 95% CI 1.55-2.99). Evaluation by a certified paramedic rather than a nonparamedic was strongly associated with receiving a prehospital ECG among patients with chest pain (RR 2.15; 95% CI 1.55-2.99).
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