M E M O   / N O T E   D E   S E R V I C E


To / Destinataire

Acting Mayor and Members of Council/Maire par intérim et Membres du Conseil

File/N° de fichier:


From / Expéditeur

Chief Ottawa Paramedic Service/ Chef du Service paramédic d’Ottawa


Subject / Objet

2009 Research Award Pre-identification of STEMI - IPD / Prix de recherche 2009 pour le dépistage précoce de l’IAMEST – IDA

Date: May 25, 2009 / le 25 mai 2009




The purpose of this memo is to highlight the Ottawa Paramedic Service involvement in research of pre-hospital identification of a specific type of heart attack patients known as STEMI (ST elevation myocardial infarction). An elite group of Ottawa Paramedics worked jointly with a team of researchers from the Regional Paramedic Program of Eastern Ontario and the Ottawa Heart Institute on the research project. 


At the National Association of Emergency Medical Services Physicians  (NAEMSP) conference in January 2009, the team was presented the award for Best EMS Professional Research Presentation.


The most notable item from the research is that Paramedics are extremely proficient in detecting STEMI patients.  The research was conducted on a sample taken from June 2007 through February 2008 of 1266 consecutive paramedic responses to cardiac type patients.


National Award for Best EMS Professional Research Presentation

Pre-Hospital identification of ST Elevated Myocardial Infarction.

An evaluation of independent ECG interpretation by Ottawa Paramedics


Research Team:  back row: Dr. Justin Maloney, Ed Ouston ACP, Deanna Schofield ACP, Dr. Michel Lemay, Jeremy Dougherty ACP, Peter Kelly ACP, John Trickett BScN , Dr. Richard Dionne, Jeanny Verdon BscApp, Pierre Poirier ACP Debbie Charbonneau HRA, , (absent from photo), Dr. Ian Stiell


How to attack a heart attack?  Answer: A good patient assessment and an accurate, rapid interpretation of a 12 lead Electrocardiogram ECGs.  Previously ECGs were done only in the Hospital Emergency Department. But what if it we can do it earlier?  A team of researchers from the Regional Paramedic Program for Eastern Ontario the Ottawa Heart Institute and the Ottawa Paramedic Service has been recognized with an award from the National Association of Emergency Medical Services Physicians  (NAEMSP) for showing us how.  Their groundbreaking study demonstrated that paramedics with enhanced training could identify a STEMI heart attack (STEMI) as accurately as physicians. 


For the 8-month period, June 2007 to February 2008, the team reviewed 1266 consecutive ambulance responses for patients with possible cardiac chest pain, of which 560 cases met the inclusion criteria.  Paramedics obtained ECGs on these patients and identified those with a STEMI.  A panel of physicians later reviewed the ECGs, providing the gold standard reading without prior knowledge of the paramedic or the ECG monitor software interpretations.  Because these Ottawa paramedics are able to identify STEMI at the scene with a high degree of accuracy, there is no need to delay patient treatment or transport.  Previously paramedics would be required to transmit electronically an ECG and await a physician’s interpretation before treating or transporting the patient to the appropriate care facility. This important research is proof that the Ottawa Paramedic Service is showing the world how to improve time to treatment for these STEMI patients.  A one-page synopsis of the evaluation of independent ECG interpretation by trained paramedics is attached for your information.



Original signed by Anthony Di Monte


Anthony Di Monte

Chief, Ottawa Paramedic Service



            Deputy City Manager, City Operations

            General Manager, Emergency and Protective Services