Now evaluate chest pain with 12-lead electrocardiograms and rapid markers for early recognition of myocardial infarctions in the ambulance (NEW ERA)

Introduction: Paramedics play a vital role in the diagnosis of acute myocardial infarction (AMI). Rapid bedside cardiac markers (RBCMs) are an additional tool that may be used to identify patients with AMI and non-diagnostic ECGs. Study Objectives: This study was performed to determine if paramedics can identify patients with AMI by using 12-lead ECG and RBCMs. Methods: In this multi-center trial, 12-lead ECGs and RBCMs were performed before arrival to the emergency department (ED). AMI was identified if either pre-hospital 12-lead ECG or RBCM were positive. Results: Of the 247 enrolled patients, 28 (11.3%) patients were identified with AMI in the pre-hospital setting. Of the 9 AMI missed by EMS, all had initial pre-hospital negative RBCMs but subsequent positive RBCMs in the ED. Conclusion: Paramedics can identify AMI in the pre-hospital setting using 12-lead ECG and RBCMs. Presented at: American College of Emergency Physicians Research Forum, Las Vegas, October 1999 Funding: Rapid Bedside Cardiac Markers were supplied by Spectral Diagnostics. Cellular phones were supplied by Motorola. Airtime was donated by Ameritech. The 12-Lead ECG Monitors were supplied by Physio-Control. No additional compensation was obtained.