Field EKG Transmission Project

Union Hospital’s Richard G. Lugar Center for Rural Health has partnered with rural ambulance companies in Parke, Sullivan, and Vermillion counties in Indiana to implement an innovative low cost sustainable electrogardiogram (EKG) transmission solution for rural counties utilizing the Physioglove by Commwell.

These counties have alarmingly high cardiac mortality rates.

From the minute chest pain starts, blood supply to the heart is reduced. For every second that goes by, more heart muscle is damaged beyond repair. The glove reads and transmits the heart tracing enabling care providers to determine if a heart attack is occurring at the first point of patient contact. This identification allows patients suffering from certain types of heart attacks to be routed more quickly to a facility that can offer important and time sensitive treatment.

The goal of the project is to implement a process that facilitates the rapid transport of rural residents to the heart attack care they need within 90 minutes.

In order to implement the Field ST elevation Myocardial Infarction (STEMI) EKG Transmission project, many partners have worked together including Emergency Medical Services (EMS), dispatch, emergency departments, hospital admitting departments, physicians, nursing staff, cardiac catheterization teams, and cardiologists. A written waiver has been obtained from the Indiana State Emergency Medical Service Commission to carry out the study and evaluate its impact. The study was submitted to and approved by the Institutional Review Board at Indiana University.

Rural EMS providers have received the technology and training to identify these potentially deadly heart attacks. EKGs obtained before arriving at the hospital can ensure that patients arrive at a facility most suited to their medical needs. The protocols and practice guidelines are based on proven medical guidelines. The program has provided training and staff development related to both equipment and processes.

Outcomes: (January 2012-October 2013)

Since the start of the program, county ambulance staffs have successfully transmitted 214 EKGs for residents experiencing chest pain.

Twelve patients experiencing heart attacks requiring the care of a cardiologist were transported directly to hospitals equipped to provide emergency cardiac care services.
Door-to-balloon times for rural residents in the project area were reduced by an average of 40 minutes.
Every STEMI patients that received pre- hospital EKG transmission experienced a “field EKG to balloon time” of 90 minutes or less which is the nationally recognized standard.

If you or someone you know is experiencing any of the following symptoms call 911 immediately.

Pain or pressure in the chest lasting more than a few minutes; pain in the arm, back, teeth or jaw; shortness of breath; pain in the upper abdomen; sweating, feelings of doom; fainting or dizziness; heartburn, clammy skin; nausea and vomiting.

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This program was funded by the Health Resources and Services Agency (HRSA) Office for Advancement of Telehealth (OAT) (Grant # H2ARH20178).