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Background <p>Prehospital 12-lead electrocardiogram (ECG) improves outcomes in ST-segment elevation myocardial infarction, yet meeting the 10-minute target from first medical contact remains difficult. We evaluated determinants of faster prehospital ECG performance.</p> Methods <p>We analysed a prefecture-wide registry in Japan (September 2021 to August 2025) of patients with suspected acute coronary syndrome who had prehospital ECG transmission. Prehospital ECG performance was assessed using the scene-to-ECG interval, from emergency medical services (EMS) on-scene arrival to ECG transmission. The primary outcome was scene-to-ECG ≤ 10&#xa0;min; the secondary outcome was interval length. Agency experience was measured by cumulative ECG transmissions. Mixed-effects logistic and linear models with agency random intercepts were used with adjustment for age, sex, and time of arrival.</p> Results <p>Of 1,748 patients, 672 (38.4%) achieved ≤ 10&#xa0;min; the median scene-to-ECG was 12&#xa0;min (interquartile range 9 to 17). Greater cumulative transmissions were associated with higher odds of ≤ 10&#xa0;min (adjusted odds ratio 1.07 per 100 cases, 95% confidence interval 1.02 to 1.14) and shorter intervals (β − 0.29&#xa0;min per 100 cases, 95% confidence interval − 0.39 to − 0.19). Older age, female sex, and nighttime arrival were associated with lower odds of achieving ≤ 10&#xa0;min, whereas older age and nighttime arrival were associated with longer intervals.</p> Conclusions <p>At the EMS agency level, higher cumulative ECG transmissions were associated with achieving the ≤ 10-minute scene-to-ECG target. This suggests that focused onboarding and continued EMS training may enhance prehospital ECG performance. In the main analysis, older age, female sex, and nighttime arrival were associated with lower odds of achieving the target.</p>

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Factors associated with achieving the 10-minute scene-to-ECG transmission target in prehospital care: the role of EMS agency-level cumulative ECG transmissions

  • 期刊论文

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  • 发表日期：

    2026年5月29日

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  • Hiroki Sato,
  • Kunio Yufu,
  • Tatsunori Nakashima,
  • Hidefumi Akioka,
  • Ryuzo Abe,
  • Tsuyoshi Shimomura,
  • Naohiko Takahashi

摘要

Background

Prehospital 12-lead electrocardiogram (ECG) improves outcomes in ST-segment elevation myocardial infarction, yet meeting the 10-minute target from first medical contact remains difficult. We evaluated determinants of faster prehospital ECG performance.

Methods

We analysed a prefecture-wide registry in Japan (September 2021 to August 2025) of patients with suspected acute coronary syndrome who had prehospital ECG transmission. Prehospital ECG performance was assessed using the scene-to-ECG interval, from emergency medical services (EMS) on-scene arrival to ECG transmission. The primary outcome was scene-to-ECG ≤ 10 min; the secondary outcome was interval length. Agency experience was measured by cumulative ECG transmissions. Mixed-effects logistic and linear models with agency random intercepts were used with adjustment for age, sex, and time of arrival.

Results

Of 1,748 patients, 672 (38.4%) achieved ≤ 10 min; the median scene-to-ECG was 12 min (interquartile range 9 to 17). Greater cumulative transmissions were associated with higher odds of ≤ 10 min (adjusted odds ratio 1.07 per 100 cases, 95% confidence interval 1.02 to 1.14) and shorter intervals (β − 0.29 min per 100 cases, 95% confidence interval − 0.39 to − 0.19). Older age, female sex, and nighttime arrival were associated with lower odds of achieving ≤ 10 min, whereas older age and nighttime arrival were associated with longer intervals.

Conclusions

At the EMS agency level, higher cumulative ECG transmissions were associated with achieving the ≤ 10-minute scene-to-ECG target. This suggests that focused onboarding and continued EMS training may enhance prehospital ECG performance. In the main analysis, older age, female sex, and nighttime arrival were associated with lower odds of achieving the target.