Prehospital Telemedicine: The Solution to Reduce Treatment Delays and Mortality in ST-Elevation Myocardial Infarction and Acute Ischemic Stroke

Main Article Content

Parkin Paramiraksa
Chirakit Hengrasmee
Tanutporn Luxsasupavanich


Introduction (Aims and Problem Statement)

ST-elevation myocardial infarction (STEMI) and acute ischemic stroke (AIS) reperfusion treatment are critically time-dependent. The longer time to reperfusion strongly correlates with higher mortality and adverse outcomes.

In developing countries, common causes of the delay in prehospital care are the lack of professional prehospital healthcare providers and collaboration among organizations. Moreover, hospitals capable of providing reperfusion treatment are limited. 

Telemedicine has facilitated the reach of specialists for remote triage and diagnosis in prehospital settings.

This white paper aims to examine the efficacy of telemedicine in reducing treatment delays and mortality and to propose strategies and policies to implement telemedicine in prehospital care for STEMI/ AIS management.


A search of MEDLINE, EMBASE, PubMed, and Scopus was performed, and studies will be systematically reviewed by two reviewers; if consensus is required, a third reviewer will be consulted. 


Out of 446 reviewed articles, 64 met the criteria and were critically analyzed; 36 and 28 studies focused on STEMI and AIS, respectively.


Overall, the reviewed studies suggested that implementing telemedicine in prehospital care efficiently reduced time to reperfusion and lower mortality.


The common limitation in developing countries is the absence of efficient technological and medical devices in ambulances.

Proposed Solutions: 

The following solutions are suggested:

  • Devise the STEMI/ AIS network and facilitate the implementation of telemedicine to collaborate between pre-hospital healthcare providers and on-call specialists; therefore, remote diagnosis and triage are efficiently performed, then patients are transported to the prealerted potential hospital for immediate definitive treatment.


  • The ambulances should be well-equipped with reliable 12-lead Electrocardiogram, high-resolution video camera, and stable network connection that enable effective telemedicine practice, with minimum delays.


  • Pre-hospital health care providers should be trained to proficiently work in novel telemedicine implemented pre-hospital care.


Implementing pre-hospital telemedicine with well-equipped ambulances can reduce time to reperfusion, mortality rate, and adverse complication in STEMI/ AIS. 

Keywords: ST-elevation myocardial infarction; Acute ischemic stroke; Telemedicine; Treatment delay; Prehospital care; Emergency medicine

Article Details

How to Cite
Paramiraksa, P., Hengrasmee, C., Sae-sow, K. and Luxsasupavanich, T. (2022) “Prehospital Telemedicine: The Solution to Reduce Treatment Delays and Mortality in ST-Elevation Myocardial Infarction and Acute Ischemic Stroke”, Journal of Asian Medical Students’ Association. Kuala Lumpur, Malaysia. Available at: (Accessed: 3December2022).
Photography (EAMSC 2023 Nepal)


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