Although widely used in Europe, the prehospital 12-lead electrocardiogram (
EKG) has seen only limited use in this country. Reported benefits of the 12
-lead EKG include shortening the door-to-needle time, accelerating the init
iation of reperfusion therapy, and overall improving the prehospital and ho
spital management and outcome of patients with acute myocardial infarction,
The field EKG also provides the basis for prehospital fibrinolysis. Concer
ns still exist, however, regarding the best means of providing real-time fi
eld interpretation of the prehospital EKG and the potential for inappropria
te field time delay, triage, and treatment of patients. Moreover, questions
remain about the overall clinical and cost benefit of expanding this resou
rce universally. The following article reviews the role of prehospital EKG
in caring for patients with acute coronary syndromes, (C) 2001 Elsevier Sci
ence Inc.