Clinical Events and Treatment in Prehospital Patients with ST-segment Elevation Myocardial Infarction

AbstractBackground. Little is known about clinically important events and advanced care treatment that patients with ST-segment elevation myocardial infarction (STEMI) encounter in the prehospital setting. Objectives. We sought to determine the proportion of community patients with STEMI who experienced a clinically important event or received advanced care treatment prior to arrival at a designated percutaneous coronary intervention (PCI) laboratory or emergency department (ED). Methods. We reviewed 487 consecutive community patients with STEMI between May 2008 and June 2009. All patients were geographically within a single large “third-service” urban emergency medical services (EMS) system and were transported by paramedics with an advanced care scope of practice. We recorded predefined clinically important events and advanced care treatment that occurred in patients being transported directly to a PCI laboratory or ED (group 1) or interfacility transfer to a PCI laboratory (group 2). Results. One or mo...