Trying to follow the logic in this news piece. OK, so “the American Heart Association (AHA) has issued a statement highlighting the need to implement prehospital 12-lead electrocardiogram (ECG) assessments to improve acute coronary syndrome management.” Got it. References the work of Henry Ting at Mayo:
It is a lost opportunity to improve the quality of care for STEMI patients if the information from a prehospital ECG is not used to change downstream processes of care.
But then it has a link to “Free abstract,” which is about NSTE-ACS (non–ST-elevation acute coronary syndromes, which includes NSTEMI). OK now, so what does an article about NSTE-ACS or NSTEMI have to do with paramedics using ECGs to detect STEMIs? Zip! An ECG in the prehospital setting showing no ST segment elevation is not-helpful, non-diagnostic and potentially prejudicial in subsequent evaluation and treatment, because “the ECG was normal.” An ECG can only be in one of two states: diagnostic or non-diagnostic, it is never “normal.” There is no such beast! Two patient I’ve seen in the last month with “normal ECGs” and poorly described or no chest pain had troponins of 29 and 6.
No ST segment elevation in the inferior leads (III and aVF)
A last bit of irony, the quote attributed to Ting is not found in the article cited nor is Ting an author.