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Prehospital detection of acute ST-segment-elevation myocardial infarction (STEMI) facilitates transport of patients directly to percutaneous coronary intervention (PCI)-capable centers, and earlier detection lowers mortality. To assess whether performance of serial electrocardiograms (ECGs) improves detection of STEMI, researchers reviewed records for 325 consecutive patients with STEMI who were transported by the Toronto emergency medical services (EMS) system during 1 year.
If STEMI was not detected on the first ECG in a patient with symptoms suggestive of myocardial ischemia, the EMS protocol required performing a second ECG after the patient was loaded into the ambulance and, if necessary, a third ECG in the ambulance bay at the receivin…