CONGRESS ABSTRACT

In out-of-hospital emergencies, timely assistance is crucial, especially for symptoms such as chest pain, syncope, sweating, palpitations, vomiting, or jaw/shoulder pain, often associated with myocardial infarction or potentially life-threatening arrhythmias. Early prehospital EKG performance by EMS personnel, particularly when Advanced Life Support (ALS) units are unavailable, enables EKG transmission, early identification of critical findings, and prehospital therapeutic decision-sharing with the Emergency Operations Center physician and/or the reference Cardiology Department. This structured approach facilitates the selection of the most appropriate destination hospital, reducing treatment delays. During the first five years of the Telemed Project in Lazio Region (2017–2021), 23,688 valid EKGs were transmitted. Among these, 1,723 were diagnosed as STEMI, and 6,258 as NSTEMI. Of the STEMI cases, 1,539 were centralized, while 184 were transported to the nearest emergency department due to hemodynamic instability. Data from Latina Province were excluded. EKG transmissions, interrupted during the Sars-Cov2 pandemic, resumed in Rieti, Viterbo, Frosinone, and Latina Provinces and are expected to restart soon in Rome and its surrounding areas. In addition to patients presenting with cardiovascular symptoms such as chest pain, the project aims to expand its scope to include arrhythmias, characterized by alterations in normal electrical activity such as tachycardia, bradycardia, or nonspecific electrocardiographic changes. Arrhythmias require prompt intervention to stabilize the patient and prevent serious complications such as cardiac arrest. The Telemed system provides the following advantages: 1. Transmission of 12-lead EKGs for immediate interpretation of: • Bradyarrhythmias • Regular wide-complex tachyarrhythmias • Regular narrow-complex tachyarrhythmias • Irregular wide-complex tachyarrhythmias • Irregular narrow-complex tachyarrhythmias 2. Rapid decision-making support through teleconsultation. 3. Activation of advanced procedures when necessary, such as synchronized electrical cardioversion or transcutaneous pacing, tailored to the type of EMS unit involved (nurseled or physician-led).