A modified cardiac triage strategy reduces door to ECG time in patients with ST elevation myocardial infarction
Abstract Timely performing electrocardiography (ECG) is crucial for early detection of ST-elevation myocardial infarction (STEMI). For shortening door-to-ECG time, a chief complaint-based “cardiac triage” protocol comprising (1) raising alert among medical staff with bedside triage tags, and (2) imm...
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Nature Portfolio
2021
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oai:doaj.org-article:8ef1216ecdad41de9178ba6b192067c72021-12-02T17:04:59ZA modified cardiac triage strategy reduces door to ECG time in patients with ST elevation myocardial infarction10.1038/s41598-021-86013-82045-2322https://doaj.org/article/8ef1216ecdad41de9178ba6b192067c72021-03-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-86013-8https://doaj.org/toc/2045-2322Abstract Timely performing electrocardiography (ECG) is crucial for early detection of ST-elevation myocardial infarction (STEMI). For shortening door-to-ECG time, a chief complaint-based “cardiac triage” protocol comprising (1) raising alert among medical staff with bedside triage tags, and (2) immediate bedside ECG after focused history-taking was implemented at the emergency department (ED) in a single tertiary referral center. All patients diagnosed with STEMI visiting the ED between November 2017 and January 2020 were retrospectively reviewed to investigate the effectiveness of strategy before and after implantation. Analysis of a total of 117 ED patients with STEMI (pre-intervention group, n = 57; post-intervention group, n = 60) showed significant overall improvements in median door-to-ECG time from 5 to 4 min (p = 0.02), achievement rate of door-to-ECG time < 10 min from 45 to 57% (p = 0.01), median door-to-balloon time from 81 to 70 min (p < 0.01). Significant trends of increase in achievement rates for door-to-ECG and door-to-balloon times (p = 0.032 and p = 0.002, respectively) was noted after strategy implementation. The incidences of door-to-ECG time > 10 min for those with initially underestimated disease severity (from 90 to 10%, p < 0.01) and walk-in (from 29.2 to 8.8%, p = 0.04) were both reduced. In conclusion, a chief complaint-based “cardiac triage” strategy successfully improved the quality of emergency care for STEMI patients through reducing delays in diagnosis and treatment.Hung-Yuan SuJen-Long TsaiYin-Chou HsuKuo-Hsin LeeChao-Sheng ChangCheuk-Kwan SunYu-Han WangShu-Ching ChiChih-Wei HsuNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-9 (2021) |
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Medicine R Science Q |
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Medicine R Science Q Hung-Yuan Su Jen-Long Tsai Yin-Chou Hsu Kuo-Hsin Lee Chao-Sheng Chang Cheuk-Kwan Sun Yu-Han Wang Shu-Ching Chi Chih-Wei Hsu A modified cardiac triage strategy reduces door to ECG time in patients with ST elevation myocardial infarction |
| description |
Abstract Timely performing electrocardiography (ECG) is crucial for early detection of ST-elevation myocardial infarction (STEMI). For shortening door-to-ECG time, a chief complaint-based “cardiac triage” protocol comprising (1) raising alert among medical staff with bedside triage tags, and (2) immediate bedside ECG after focused history-taking was implemented at the emergency department (ED) in a single tertiary referral center. All patients diagnosed with STEMI visiting the ED between November 2017 and January 2020 were retrospectively reviewed to investigate the effectiveness of strategy before and after implantation. Analysis of a total of 117 ED patients with STEMI (pre-intervention group, n = 57; post-intervention group, n = 60) showed significant overall improvements in median door-to-ECG time from 5 to 4 min (p = 0.02), achievement rate of door-to-ECG time < 10 min from 45 to 57% (p = 0.01), median door-to-balloon time from 81 to 70 min (p < 0.01). Significant trends of increase in achievement rates for door-to-ECG and door-to-balloon times (p = 0.032 and p = 0.002, respectively) was noted after strategy implementation. The incidences of door-to-ECG time > 10 min for those with initially underestimated disease severity (from 90 to 10%, p < 0.01) and walk-in (from 29.2 to 8.8%, p = 0.04) were both reduced. In conclusion, a chief complaint-based “cardiac triage” strategy successfully improved the quality of emergency care for STEMI patients through reducing delays in diagnosis and treatment. |
| format |
article |
| author |
Hung-Yuan Su Jen-Long Tsai Yin-Chou Hsu Kuo-Hsin Lee Chao-Sheng Chang Cheuk-Kwan Sun Yu-Han Wang Shu-Ching Chi Chih-Wei Hsu |
| author_facet |
Hung-Yuan Su Jen-Long Tsai Yin-Chou Hsu Kuo-Hsin Lee Chao-Sheng Chang Cheuk-Kwan Sun Yu-Han Wang Shu-Ching Chi Chih-Wei Hsu |
| author_sort |
Hung-Yuan Su |
| title |
A modified cardiac triage strategy reduces door to ECG time in patients with ST elevation myocardial infarction |
| title_short |
A modified cardiac triage strategy reduces door to ECG time in patients with ST elevation myocardial infarction |
| title_full |
A modified cardiac triage strategy reduces door to ECG time in patients with ST elevation myocardial infarction |
| title_fullStr |
A modified cardiac triage strategy reduces door to ECG time in patients with ST elevation myocardial infarction |
| title_full_unstemmed |
A modified cardiac triage strategy reduces door to ECG time in patients with ST elevation myocardial infarction |
| title_sort |
modified cardiac triage strategy reduces door to ecg time in patients with st elevation myocardial infarction |
| publisher |
Nature Portfolio |
| publishDate |
2021 |
| url |
https://doaj.org/article/8ef1216ecdad41de9178ba6b192067c7 |
| work_keys_str_mv |
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