Sonification enables continuous surveillance of the ST segment in the electrocardiogram

ST segment elevation myocardial infarction is a common reason for out-of-hospital cardiac arrest in adult patients. The surveillance of the ST segment in the electrocardiogram is limited to visual presentation. However, the ST segment can change during the course of treatment. If ST elevation is pre...

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Bibliographic Details
Published in:The American journal of emergency medicine 2022-08, Vol.58, p.286-297
Main Authors: Blanco, Andrea Lorena Aldana, Thomas, Hermann, Jens, Tiesmeier, Jan, Persson, Steffen, Grautoff
Format: Article
Language:English
Subjects:
Cardiac arrest
Cardiovascular disease
ECG
EKG
Electrocardiography
Emergency medical care
Heart attacks
Heart rate
Medical students
Monitoring
Myocardial infarction
Out-of-hospital cardiac arrest
Pain
Patients
Pulse oximetry
Sonification
STEMI
Students
Surveillance
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Summary:ST segment elevation myocardial infarction is a common reason for out-of-hospital cardiac arrest in adult patients. The surveillance of the ST segment in the electrocardiogram is limited to visual presentation. However, the ST segment can change during the course of treatment. If ST elevation is present immediate coronary revascularization is needed, therefore detecting ST elevation changes the treatment fundamentally. Sonification of the ST segment is a new method which enables the emergency team to detect intermediate changes of the ST segment. We have chosen two sonification designs which were introduced to two groups, medical students and computer science students. Twenty-one participants took part in the study. The sonification was designed for evaluation of the ST segment. The user was supposed to become empowered to distinguish between no, medium–low, medium–high or extreme ST elevation by listening to the sonification. The two groups were asked to evaluate the sounds for possible ST elevation as well as for aesthetics and usability. In a second study twenty-five medical students were taking part in a medical scenario in which sonification was played during a simulated case. The patient was suffering from a myocardial infarction, ST elevation was transient and sonification sounds were changing appropriately. The students were supposed to detect these changes and act accordingly by modifying the treatment. Both groups were able to classify ST segment elevation by listening to the sonification samples. The higher the ST segment, the better was the detection rate overall. In all of the three categories (pleasantness, informativeness and long-term listening) the Water Ambience sonification was rated higher compared to the Polarity sonification. Moreover, in the two groups that took part in the study, we found a significant difference when comparing classification performance using both sonification designs. For the group of medical students as t(20) = 4.31, p = 3.44 × 10−4, p 
ISSN:0735-6757
1532-8171
DOI:10.1016/j.ajem.2022.05.016