PREHOSPITAL 12-lead ECG- IS IT USEFUL TECHNOLOGY AND HOW DO WE GET OUR PARAMEDICS TO UTILIZE IT? Advanced Leadership Issues in EMS

The Altamonte Springs Fire Department (ASFD) purchased portable 12-lead electrocardiogram monitor/defibrillators for its Advanced Life Support (ALS) units in 1992 with subsequent purchases made as additional units were placed in service. As part of a comprehensive equipment replacement plan, these units are scheduled for replacement in FY 1999/2000. The task for selection of new cardiac monitors was delegated to the department’s EMS Research and Development Team which hypothesized that prehospital 12-lead ECGs were being underutilized by department paramedics. Descriptive and evaluative research methods were used to identify: a) previous documentation that exists to validate the provision of 12-lead prehospital electrocardiograms (ECGs) and if they affect patient outcomes; b) if the technology is being provided to patients as often as it should be; c) what situations are 12-leads currently being provided; d) what factors influence paramedics in the application of 12-lead technology in our local community as well as nation wide; e) what is the opinion of the local Emergency Medical Services (EMS) system Medical Director concerning the provision and future of 12-lead technology. The procedures employed for this project included review of written material on the application of 12-lead ECGs; personal interviews; surveys of fire departments both within Florida and nationwide; and surveys of paramedics working within the Seminole County, FL, EMS system. The findings of the project indicated there is over whelming documentation to support the continued use of prehospital 12-lead ECG technology by ASFD. The literature indicates a definite decrease in “door to drug ” times for patients identified as thrombolytic drug therapy candidates, thus having the potential to improve patient outcomes