Abstract
Objective
Our emergency department (ED) performs triage ECG for a variety of complaints to identify patients in need of treatment escalation. The aim of this study was to evaluate the existing triage ECG protocol as a means of treatment decision making.
Methods
This prospective observational study was conducted in an urban ED over one week. We recruited all patients aged 18 years and above with an undiagnosed complaint requiring a triage ECG based on the existing departmental protocol. As part of the protocol, an experienced emergency doctor then reviewed the ECG to determine the need for treatment escalation. Explicit data collection was performed using our electronic database. The outcome measures were proportions of triage treatment escalations, reasons for escalation and disposition status. Analysis was by descriptive statistics.
Results
739 patients were recruited from a total attendance of 3228. The rate of triage ECG was 23%. There were 22 (3%) triage escalations. Usually each escalation resulted from a combination of reasons. These included important ECG changes (77%), abnormal vital signs (5%) and ongoing symptoms (95%).
Conclusions
The triage ECG protocol resulted in important escalations in a small proportion of presentations. Future research is needed to refine guidelines on the use of triage ECG for different ED complaints.