Date Published: 14 April 2014

Electrocardiogram (ECG) in ambulances save lives

Recent research from English Universities in both Surrey and Leeds (West Yorkshire), suggests that people are more likely to survive a heart attack if they have an electrocardiogram (ECG) in the ambulance while on the way to hospital. An ECG is a simple test that records the rhythm and electrical activity of the heart (see also structure of the heart and functions of the heart). The research revealed that the number of patients who died within 30 days of hospital admission was significantly lower when an ECG had been carried out by an ambulance crew.

Patients who did not have an ECG in the ambulance were much less likely to receive treatments to reopen a blocked coronary artery. The use of this treatment is proven to reduce heart damage and improve the survival of patients.

Dr Chris Gale, Consultant Cardiologist and Associate Professor in the School of Medicine at Leeds University, co-authored the research, and explained that:

" The wider use of this simple, cheap and easy-to-perform test in patients suspected of having a heart attack, before they reach hospital, has the potential to save many lives and prevent premature cardiovascular death.
_ If performed by ambulance staff before reaching hospital, the ECG enables patients who are having a heart attack to receive life saving treatments much earlier. Moreover, patients with a heart attack who do not receive a ECG are less likely to receive emergency treatments on time and are more likely to die.
_ This study has identified an opportunity to provide a low cost easy-to-deliver test that will improve national cardiovascular care and outcomes."

The study also found that a third of patients admitted to hospital with a heart attack are not having the test in the ambulance, with certain groups of patients, including women, the elderly and people from black and minority ethnic groups, being less likely to have an ECG.

This research was based on analyzing data from almost half a million adults who had been admitted to hospitals in England and Wales following a heart attack.

Professor Tom Quinn of Surrey University and the lead author of this work, said:

" Every NHS ambulance is equipped with an ECG machine. While there is evidence from other countries that having an ECG test in the ambulance leads to faster treatment, our study is the first to determine that the test is actually associated with improved survival after a heart attack.
_ Ambulance services in the NHS compare favourably to countries such as the USA, where only a quarter of such patients get an ECG, but we need to do more to ensure that the groups we identified as not getting the test have improved care."

Ref. to Paper:
Tom Quinn, Sigurd Johnsen, Chris P Gale, Helen Snooks, Scott McLean, Malcolm Woollard & Clive Weston, 'Effects 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 Project' published in the journal Heart (heart.bmj.com), pub. online 14 April 2014.

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