Scientists to study to how ambulance crews can improve heart attack diagnosis

7 November 2018        

Category: Research

Scientists we fund at Kingston University and St George's, University of London, in collaboration with Swansea University and the University of Leeds, are to carry out a study to establish the best way to diagnose people suspected of a having a heart attack.

Ambulance parked outside A&E

Professor Tom Quinn has been awarded £196,500 to identify when ambulance crews should perform an electrocardiogram (ECG) on patients with a suspected heart attack. 

When someone has a suspected heart attack, ambulance crews can perform a pre-hospital ECG. Paramedics can then use the results to decide how to treat the patient, whether a patient should be taken directly to a specialist heart centre, and allow for appropriate care to be in place when the patient arrives.

Previous research carried out by Professor Quinn and colleagues in 2014 showed that people receiving the test were more likely to survive, but a third of heart attack patients, especially women and older people, were less likely to have a pre-hospital ECG. However, since that work was conducted the preferred way to treat a heart attack has changed. 

Survival rates

The scientists will study UK wide data on the treatment of heart attack patients to determine if use of the ECG is still associated with improved survival rates for heart attack patients. 

When their original work was conducted, clot-busting drugs were the principal treatment for a heart attack. Whereas today, primary angioplasty - where a blocked artery is widened using a stent – is the preferred treatment.

They will also carry out chart reviews and focus groups with paramedics from three ambulance services to understand when they use the diagnostic tool and the decision making process behind it. 

By gaining an understanding of what influences the use of ECGs by ambulance crews, the researchers hope to be able to improve guidance on when they could be used more effectively. 

Saving lives

Tom Quinn, Professor of Cardiovascular Nursing, said: “Paramedics play a crucial role in early assessment of patients with suspected heart attack. There is little evidence to date about how paramedics make the decision to perform an ECG, including when the patient does not have typical heart attack symptoms.

“By looking at nationwide data on the treatment of heart attacks and by speaking to ambulance crews working on the frontline we hope to develop a clearer picture of when these ECGs should be used. 

“We can use this knowledge to empower ambulance crews, help them make the most effective decisions and ultimately save more lives.”

A pre-hospital ECG is a test that paramedics can perform on someone with acute chest pain. The device measures electrical activity in the heart through a series of wires attached to the patient’s chest. The test, which takes about 10 minutes to perform, can diagnose a heart attack.

In the UK there are nearly 200,000 hospital visits each year due to heart attacks: the equivalent of one every three minutes. In the 1960s more than 7 out of 10 heart attacks in the UK were fatal, however, advances in treatment mean that today at least 7 out of 10 people survive.

Read more about our heart attack research