Pre-hospital ECG in acute coronary syndromes: PHECG2

  • Research type

    Research Study

  • Full title

    Use and impact of the pre-hospital 12-lead electrocardiogram in the primary PCI era. Mixed method study (PHECG-2).

  • IRAS ID

    248748

  • Contact name

    Tom Quinn

  • Contact email

    t.quinn@sgul.kingston.ac.uk

  • Sponsor organisation

    Kingston University

  • Duration of Study in the UK

    1 years, 6 months, 29 days

  • Research summary

    The Pre-Hospital 12-lead electrocardiogram (PHECG) is a simple test that helps ambulance clinicians assess patients with suspected acute coronary syndrome (heart attack), and helps to inform ongoing care, such as direct transfer to a specialist heart attack centre. All NHS emergency ambulances carry this equipment. This project builds on previous work by this team, which found that one in three eligible patients did not receive a PHECG, but those that did had a lowered risk of short-term death. Women, the elderly and people with more complex health status were less likely to receive PHECG. The dominant treatment for heart attack at the time of our earlier analysis was 'clot buster' drug therapy (fibrinolysis). In this study we will update that work, in the context of the shift in recent years to a more interventional strategy for treatment of heart attack (angioplasty and stents), and explore reasons for variations in practice -highlighting opportunities to improve care and outcomes.

    Using routinely collected data from a large national audit, a review of ambulance records, and qualitative methods, we will assess the association of having PHECG with patient outcomes, and research patient, practitioner and contextual factors contributing to the decision to record (or not) a PHECG. We will aim subsequently to develop an intervention to increase the proportion of eligible patients that receive a PHECG, and to produce a proposal for further funding to test this intervention in a subsequent randomised trial.

  • REC name

    London - Hampstead Research Ethics Committee

  • REC reference

    18/LO/1679

  • Date of REC Opinion

    29 Oct 2018

  • REC opinion

    Further Information Favourable Opinion