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J Accid Emerg Med. 1997 September; 14(5): 307–310.
PMCID: PMC1343097

Assessment of the value of technician reporting of electrocardiographs in an accident and emergency department.


OBJECTIVE: To assess the value of a cardiac technicians' report on electrocardiographs (ECGs) in reducing serious errors of interpretation by senior house officers. METHODS: A parallel study of interpretation of ECGs by senior house officers from 238 cases seen in an accident and emergency (A&E) department in a teaching hospital. 129 ECGs were reported by a cardiac technician at the time of recording and before the senior house officer wrote a report, and 109 were reported only by the senior house officers. Misinterpretations by doctors and technicians were graded by a consultant cardiologist on a four point scale and compared in the two groups. Serious errors (grade 4) were defined as those which potentially affected immediate management. RESULTS: The number of grade 4 errors of interpretation of ECGs by A&E senior house officers was reduced by 59% when there was a prior technical report (mean (SD), 18(17)% v 6 (7%); Fisher's exact test P < 0.05). CONCLUSIONS: When cardiac technicians provide a report on an ECG at the time of its recording, serious errors of interpretation by senior house officers are reduced.

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Selected References

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  • Verstraete M. Thrombolytic treatment. BMJ. 1995 Sep 2;311(7005):582–583. [PMC free article] [PubMed]
  • Davie AP, Francis CM, Love MP, Caruana L, Starkey IR, Shaw TR, Sutherland GR, McMurray JJ. Value of the electrocardiogram in identifying heart failure due to left ventricular systolic dysfunction. BMJ. 1996 Jan 27;312(7025):222–222. [PMC free article] [PubMed]
  • Emerson PA, Russell NJ, Wyatt J, Crichton N, Pantin CF, Morgan AD, Fleming PR. An audit of doctor's management of patients with chest pain in the accident and emergency department. Q J Med. 1989 Mar;70(263):213–220. [PubMed]
  • McCallion WA, Templeton PA, McKinney LA, Higginson JD. Missed myocardial ischaemia in the accident & emergency department: E.C.G. a need for audit? Arch Emerg Med. 1991 Jun;8(2):102–107. [PMC free article] [PubMed]
  • Morrison WG, Swann IJ. Electrocardiograph interpretation by junior doctors. Arch Emerg Med. 1990 Jun;7(2):108–110. [PMC free article] [PubMed]
  • Westdrop EJ, Gratton MC, Watson WA. Emergency department interpretation of electrocardiograms. Ann Emerg Med. 1992 May;21(5):541–544. [PubMed]
  • Gjørup T, Kelbaek H, Nielsen D, Kreiner S, Godtfredsen J. Interpretation of the electrocardiogram in suspected myocardial infarction: a randomized controlled study of the effect of a training programme to reduce interobserver variation. J Intern Med. 1992 Apr;231(4):407–412. [PubMed]
  • White T, Woodmansey P, Ferguson DG, Channer KS. Improving the interpretation of electrocardiographs in an accident and emergency department. Postgrad Med J. 1995 Mar;71(833):132–135. [PMC free article] [PubMed]
  • Berman L, de Lacey G, Twomey E, Twomey B, Welch T, Eban R. Reducing errors in the accident department: a simple method using radiographers. Br Med J (Clin Res Ed) 1985 Feb 9;290(6466):421–422. [PMC free article] [PubMed]
  • Willems JL, Abreu-Lima C, Arnaud P, van Bemmel JH, Brohet C, Degani R, Denis B, Gehring J, Graham I, van Herpen G, et al. The diagnostic performance of computer programs for the interpretation of electrocardiograms. N Engl J Med. 1991 Dec 19;325(25):1767–1773. [PubMed]

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