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Arch Emerg Med 1991;8:102-107 doi:10.1136/emj.8.2.102
  • Research Article

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

  1. W A McCallion,
  2. P A Templeton,
  3. L A McKinney,
  4. J D Higginson
  1. Accident and Emergency Department, Ulster Hospital, Dundonald, Belfast, Northern Ireland.

      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.

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