EMS protocol gaps for defibrillator pad placement in prehospital STEMI care.

Λεπτομέρειες βιβλιογραφικής εγγραφής
Τίτλος: EMS protocol gaps for defibrillator pad placement in prehospital STEMI care.
Συγγραφείς: Packel C; Drexel University College of Medicine, Reading, USA., Costa S; Department of Emergency Medicine, WellSpan York Hospital, York, USA; WellSpan EMS, WellSpan Health, York, USA., Flamm A; Drexel University College of Medicine, Reading, USA; Department of Emergency Medicine, WellSpan York Hospital, York, USA; WellSpan EMS, WellSpan Health, York, USA. Electronic address: aflamm@wellspan.org.
Πηγή: The American journal of emergency medicine [Am J Emerg Med] 2026 Aug; Vol. 106, pp. 30-32. Date of Electronic Publication: 2026 Apr 21.
Τύπος έκδοσης: Journal Article
Γλώσσα: English
Στοιχεία περιοδικού: Publisher: W B Saunders Country of Publication: United States NLM ID: 8309942 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1532-8171 (Electronic) Linking ISSN: 07356757 NLM ISO Abbreviation: Am J Emerg Med Subsets: MEDLINE
Imprint Name(s): Publication: 1983- : Philadelphia, PA : W B Saunders
Original Publication: [Philadelphia, PA. : Centrum Philadelphia, c1983]-
Ιατρικοί όροι (MeSH): ST Elevation Myocardial Infarction*/therapy , Emergency Medical Services*/standards , Emergency Medical Services*/methods , Defibrillators* , Clinical Protocols* , Electric Countershock*, Death, Sudden, Cardiac/prevention & control ; Humans ; Cross-Sectional Studies ; Electrocardiography ; United States ; Practice Guidelines as Topic
Περίληψη: Background: Patients experiencing ST-segment elevation myocardial infarction (STEMI) face a significant risk of sudden cardiac arrest (SCA) in the prehospital setting, often presenting as shockable rhythms. Early defibrillation is critical to survival, and preemptive placement of defibrillator pads may reduce time to shock. However, the extent to which EMS protocols recommend this practice remains unclear.
Objective: To assess the prevalence and specificity of guidance on defibrillator pad placement for STEMI patients in U.S. EMS protocols and identify gaps in prehospital care.
Methods: We conducted a cross-sectional review of 30 publicly available state-wide EMS protocols or recommendations. We analyzed Protocols for recommendations on defibrillator pad placement during STEMI transport, ECG acquisition timing, and hospital notification. Findings were summarized using descriptive statistics.
Results: Only 13% of protocols explicitly advised placing defibrillator pads on STEMI patients during transport, while 17% suggested considering pad placement. The remaining 70% provided no guidance. Few protocols specified ECG acquisition timing goals (33%), though 67% emphasized early STEMI notification to receiving hospital.
Conclusions: EMS protocol guidance on defibrillator pad placement for STEMI patients remains limited and variable. Most protocols lack clear recommendations, potentially delaying rapid defibrillation during cardiac arrest. Further research should assess the clinical impact, cost-effectiveness, and implementation barriers of routine preemptive pad placement during STEMI transport.
(Copyright © 2026 Elsevier Inc. All rights reserved.)
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
Contributed Indexing: Keywords: Acute coronary syndrome; Defibrillation; STEMI
Entry Date(s): Date Created: 20260430 Date Completed: 20260607 Latest Revision: 20260723
Update Code: 20260724
DOI: 10.1016/j.ajem.2026.04.029
PMID: 42061201
Βάση Δεδομένων: MEDLINE
Περιγραφή
ISSN:1532-8171
DOI:10.1016/j.ajem.2026.04.029