Early Cath Lab Activation By Emergency Medical Technicians: Improving Outcomes For Patients With Acute Coronary Syndromes

Abstract

Early activation of the cardiac catheterization laboratory (cath lab) is critical in reducing door-to-balloon (D2B) times and improving survival rates in patients with acute coronary syndromes (ACS), particularly ST-segment elevation myocardial infarction (STEMI). Emergency Medical Technicians (EMTs), as frontline responders, play a pivotal role in this process by identifying candidates for urgent percutaneous coronary intervention (PCI) and initiating cath lab activation before hospital arrival. This review synthesizes current evidence on EMT-driven cath lab activation, highlighting its impact on system efficiency, clinical outcomes, and healthcare resource utilization. Studies demonstrate that pre-hospital electrocardiogram (ECG) transmission and EMT-facilitated communication with interventional cardiology teams significantly reduce treatment delays. Furthermore, early activation protocols have been associated with improved myocardial salvage, decreased infarct size, and reduced mortality. Despite these benefits, challenges remain in the form of diagnostic accuracy, regional disparities in pre-hospital systems, and ethical considerations regarding over-activation. Advances in telemedicine and artificial intelligence may enhance EMT decision-making and support broader implementation. By examining clinical evidence, technological innovations, and systemic challenges, this article underscores the essential role of EMTs in bridging pre-hospital and in-hospital care to optimize outcomes for ACS patients.