"The pertinent measure of system performance is from the time of first medical contact with paramedics or other emergency medical personnel to reperfusion therapy," said lead author of the statement Henry H. Ting, MD, Mayo Clinic, Rochester, Minnesota.

Dr. Ting and colleagues evaluated progress since ST-segment elevation myocardial infarction (STEMI) guidelines were first issued by the American Heart Association and the American College of Cardiology in 2004. They were updated last year. The guidelines recommend that all emergency medical services acquire and use prehospital electrocardiograms to evaluate patients

with suspected acute coronary syndromes.

"If prehospital ECGs were more widely used and integrated with systems of care, the time from first medical contact to balloon reperfusion could be reduced to less than 60 minutes," Dr. Ting said. The recommended goal is 90 minutes or less.

Despite the recent recommendations, fewer than 10% of EMS systems have adopted the use of prehospital ECGs, and the rate has not substantially changed since the mid-1990s.

"Furthermore, even when a prehospital ECG is acquired, the information is often not translated into effective action to decrease

delays in treatment," Dr. Ting said. "It is a lost opportunity to improve the quality of care for STEMI patients if the information from a prehospital ECG is not used to change downstream processes of care."

SOURCE: American Heart Association