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Qual Improv Health Care > Volume 20(1); 2014 > Article
Quality Improvement in Health Care 2014;20(1): 12.
DOI: https://doi.org/10.14371/QIH.2014.20.1.12    Published online July 30, 2014.
흉통을 주소로 응급실에 내원한 환자에서 심전도 촬영 소요 시간에 대한 응급벨 제도의 효과
김민우1, 오상훈1, 박규남1, 이정민2, 이영미2, 김한준1, 김수현1, 강동재1
1가톨릭대학교 의과대학 응급의학교실
2서울성모병원 응급의학과
Effect of emergency bell on door to ECG time in walk-in patients presented to emergency department with chest pain
Min-Woo Kim1, Sang-Hoon Oh1, Kyu-Nam Park1, Jung-Min Lee2, Young-Mee Lee2, Han-Joon Kim1, Soo-Hyun Kim1, Dong-Jae Kang1
1Department of Emergency Medicine, College of Medicine, The Catholic University of Korea
2Department of Emergency Team, Emergency Medical Center, Seoul St. Mary Hospital
The aim of this study was to explore whether emergency bell could shorten door to electrocardiograms (ECG) time in chest pain patients presenting to emergency department (ED) by self-transport.
This was a planned 6-month before-and-after interventional study design. We set up the emergency bell in walk-in patients' waiting room. Prior to the change, patients were triaged before an ECG was obtained. In new process, as soon as patient with chest pain push the emergency bell, emergency physicians examined patient and prioritized performing ECG. We analyzed door to electrocardiograms (DTE) times for patients with chest pain and ST segment elevation myocardial infarction (STEMI) patients between two periods.
During the enrollment period, a total of 63 patients called emergency bell. The median DTE time was 6 min (interquartile range: 3.0 - 9.0) and 82.5% received an ECG within 10 minutes, and only three patients were STEMI. DTE time in patient with chest pain was not different between two periods (p=0.980). Before intervention period, 15 walk-in patients admitted in ED for STEMI and 53.8% of STEMI patients received an ECG within 10 minutes. After intervention period, total 19 walk-in patients admitted in ED for STEMI. Of these, 89.5% met the time requirement.
Because a small portion of patients with chest pain activated the emergency bell, new strategy for promotion of emergency bell must be needed.
Key words Electrocardiography;Chest pain;Reperfusion;
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