Posted Tuesday 6 November 2018
Healthcare experts at Kingston University and St George's, University of London are leading a study to establish the best way to diagnose people suspected of having a heart attack, after being awarded a grant from the British Heart Foundation (BHF).
A team headed by Professor of Cardiovascular Nursing Tom Quinn, from the Faculty of Health, Social Care and Education run jointly by Kingston and St George's, has been awarded £196,500 to identify when ambulance crews should perform an electrocardiogram (ECG) on patients. Professor Quinn, and colleagues from the Faculty's emergency, Cardiovascular and Critical Care Research Group, will collaborate with Swansea University and the University of Leeds.
When someone has a suspected heart attack, ambulance crews can perform a pre-hospital lead 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 we were involved in showed 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," Professor Quinn said.
"When the original work was conducted, clot-busting drugs were the principal treatment for a heart attack. Primary angioplasty - where a blocked artery is widened using a stent – is now the preferred treatment," Professor Quinn explained.
As part of the new study, the researchers will examine national data on the treatment of heart attack patients to see if ECG use is still associated with improved survival rates.
The researchers will also conduct chart reviews and focus groups with paramedics from three ambulance services, West Midlands Ambulance Service NHS Foundation Trust, South Western Ambulance Service NHS Foundation Trust and the Welsh Ambulance Service NHS Trust, to understand when they use the diagnostic tool and the decision-making process behind it.
"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," Professor Quinn said.
"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 which patients receive the ECG test and how paramedics decide to do the test.
"We can use this knowledge to empower ambulance crews, help them make the most effective decisions and ultimately improve outcomes from heart attack," he added.
Dr Subreena Simrick, Senior Research Advisor at the British Heart Foundation, said: "The project aimed to answer important questions about how best to treat people suspected of having a heart attack and the results could help inform the way that ambulance crews work.
"Research like this is only possible thanks to generous donations from the public," she said. "Without their continued support we would not be able to fund the work that can help us improve the treatment and care of heart patients."