救急心電図電話伝送システム　運用の実際と有用性

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タイトル別名
  • Transtelephonic ECG Recordings from Ambulance Car. Its Utility and Effectiveness.
  • Its Utility and Effectiveness
  • 運用の実際と有用性

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The innovation of transporting critically ill patients by ambulance is one of the most important developments for reducing the death rate in emergency medicine. The role of the ambulance personnel has also become more important than ever. The new system for transtelephonic electrocardiographic recording might improve emergency medicine in this system, consists of a mobile telephone and acoustic coupler. Ambulance personnel can send electrocardiograms directly to the coronary care unit, where a cardiologist can immediately interprete electrocardiographic recordings and give suggestions for management. This system is easy to handle, without any regulations, can send real time electrogram, and may be useful for reducing the death rate ambulances because each critical patient can receive proper therapeutic support ordered directly by the cardiologist. From June, 1989 to August, 1990, this system was used for 43 patients including 12 patients with cardiac diseases and 31 patients with non-cardiac diseases. In patients with cardiac emergencies, there were 2 patients with acute myocardial infarction, 4 patients with unstable angina, 4 patients with arrhythmia, and 2 patients with congestive heart failure. The electrocardiograms, which were transferred from an ambulance to the coronary care unit, showed normal sinus rhythm in 24 patients, sinus tachycardia in 5 patients, sinus bradycardia in 1 patient, atrial fibrillation in 2 patients, complete left bundle branch block in 1 patient, and cardiac asystole in 5 patients. Elevation of the ST segment occurred in 5 patients including 2 patients with a QS pattern. In each case, the ambulance personnel reported the patient's symptoms and status at the same time, and received a brief diagnosis and proper suggestion from the cardiologist in the coronary care unit. In addition, staff personnel in the coronary care unit could prepare all of the emergency equipment that would be needed in the emergency room, before the ambulance arrived at the hospital. In conclusion, this transtelephonic electrocardiographic recording system is useful not only for screening emergency patients whether with or without cardiac problems, but also for preparing equipment for emergency care before patients are transferred to the hospital.

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