IMPROVING THE INTERPRETATION OF ELECTROCARDIOGRAPHS IN AN ACCIDENT AND EMERGENCY DEPARTMENT

In this study we have examined the ability of senior house officers in the Accident and Emergency (A&E) Department to interpret electrocardi ographs (ECGs) and tested the value of a single seminar and guidelines on interpretation. We prospectively audited ECG interpretation taken from notes over a two-month period and repeated this audit following a single seminar by a consultant cardiologist and after the issue of gu idelines. A formal test of interpretation of a set of 20 ECGs by senio r house officers in A&E was also carried out. 245 case notes were revi ewed and in one third the ECG was interpreted incorrectly by senior ho use officers in A&E but incorrect clinical management followed in only 3.2% of cases. Following the intervention, 242 case notes were review ed and serious misinterpretations were halved as was the number of pat ients mismanaged as a result (1.7%). In conclusion, formal training in ECG interpretation can reduce serious errors.