Medical Student Research Fellowship for Summer 2009

Mentor: Raymond L. Fowler, MD, FACEP, Professor of Emergency Medicine
Department: Surgery, Division of Emergency Medicine, Section on EMS
Room number: E6.110
Mail Code: 75390-8890
Phone number: 214-648-3022 / 2896
E-mail: ray.fowler@utsouthwestern.edu drray@doctorfowler.com
Project title: Accuracy of ECG Interpretation of Paramedic Professionals:
Effects upon Cardiac Catheterization Laboratory Activation in the Dallas EMS Environment

Human subjects IRB approved project number (where applicable): IRB #092008-053

Animal subjects IRB approved project number (where applicable): N/A

Project Type (patient-based research, animal-based research, or basic research; this characterization is only to permit a general classification for grouping similar types of projects):

"Basic research into clinical competency and hospital acceptance of this competency"

Brief Description of Project:
With Emergency Medical Services rapidly branching into its own subspecialty in medicine, there is a current need to set standards and practice guidelines. The purpose of this project is to assess the willingness of local catheterization laboratory directors to delegate responsibility to Dallas Fire Department paramedics in cases of myocardial infarction presenting with ST segment elevation on ECGs taken on patients in the field. The goal of this project is to help create an agreement between paramedics and cath lab directors that will reduce the time lapse from ambulance arrival to patient treatment in these cases. This project has two objectives:
Objective One: Assess the competency of area EMS agency paramedics in diagnosing myocardial infarction based on ST elevation. To do this, a random sample of 100 medics will be tested on web-based ECG interpretation exam and their scores will be compared to those of practicing ER physicians.
Objective Two: Interview all local cardiac catheterization laboratory directors and assess their willingness to activate the cath lab before patient arrival based on the paramedics assessment of STEMI.
Objective Three: Gather the accuracy of cath lab activation data for statistical analysis and comparison with other urban centers.

Previous Research Activities or Publications with Medical Students:

Stefan Buca - "A Study of the Dallas Area Stroke Network and its Impact on Patient Outcome: A Joint Effort with Parkland Memorial Hospital"

Katherine Holliman-Murphy - "The Establishment of an Inter-agency Data Management Network for Urban EMS Systems"

Elizabeth Tucker - "Promoting EMS Research through a Change in Medical Protocols"

Anson Tang - "The Creation of an EMS Electronic Data Collection Project to Capture Electrocardiographic Records of Cardiac Arrest Victims via the Internet"