Skip to main content
Archives of Emergency Medicine logoLink to Archives of Emergency Medicine
. 1991 Jun;8(2):102–107. doi: 10.1136/emj.8.2.102

Missed myocardial ischaemia in the accident & emergency department: E.C.G. a need for audit?

W A McCallion 1, P A Templeton 1, L A McKinney 1, J D Higginson 1
PMCID: PMC1285749  PMID: 1888402

Abstract

Accident & Emergency Department Senior House Officers rely heavily on their ECG interpretation skills in the diagnosis and management of patients with chest pain. This prospective double-blind study was designed to test the accuracy with which Accident & Emergency Senior House Officers interpret ECGs, by comparing their interpretation with that of a Consultant Cardiologist. ECGs from 279 of 314 consecutive patients with chest pain were analysed. Ninety per cent of normal electrocardiographs and 57% of abnormal ECGs were correctly interpreted. Despite the inaccurate interpretation of 43% of abnormal ECGs, 96.5% of the patients in the study were considered to have been managed correctly. Audit of all ECGs recorded in the Accident & Emergency Department should be undertaken by someone with experience of ECG interpretation. New A&E staff should receive training in the interpretation of ECGs.

Full text

PDF

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Behar S., Schor S., Kariv I., Barell V., Modan B. Evaluation of electrocardiogram in emergency room as a decision-making tool. Chest. 1977 Apr;71(4):486–491. doi: 10.1378/chest.71.4.486. [DOI] [PubMed] [Google Scholar]
  2. Colquhoun M. C. General practitioners' use of electrocardiography: relevance to early thrombolytic treatment. BMJ. 1989 Aug 12;299(6696):433–433. doi: 10.1136/bmj.299.6696.433. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Davies A. Electrocardiographs in general practice. BMJ. 1989 Aug 12;299(6696):408–409. doi: 10.1136/bmj.299.6696.408. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Doyle Y., Conroy R., Mulcahy R. Can we improve on the diagnostic accuracy of chest pain in accident and emergency departments? Ir Med J. 1988 Nov;81(1):21–24. [PubMed] [Google Scholar]
  5. Goldman L., Cook E. F., Brand D. A., Lee T. H., Rouan G. W., Weisberg M. C., Acampora D., Stasiulewicz C., Walshon J., Terranova G. A computer protocol to predict myocardial infarction in emergency department patients with chest pain. N Engl J Med. 1988 Mar 31;318(13):797–803. doi: 10.1056/NEJM198803313181301. [DOI] [PubMed] [Google Scholar]
  6. Hedges J. R., Kobernick M. S. Detection of myocardial ischemia/infarction in the emergency department patient with chest discomfort. Emerg Med Clin North Am. 1988 May;6(2):317–340. [PubMed] [Google Scholar]

Articles from Archives of Emergency Medicine are provided here courtesy of BMJ Publishing Group

RESOURCES