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Acute coronary syndromes: 2c-ECG performed within 10 minutes of arrival to the emergency department

Indicator Attributes

Identifying and definitional attributes

Metadata item type:Help on this termIndicator
Indicator type:Help on this termIndicator
Short name:Help on this termIndicator 2c-ECG performed within 10 minutes of arrival to the emergency department
METEOR identifier:Help on this term613162
Registration status:Help on this term

Health, Standard 12/09/2016

Description:Help on this term

Proportion of patients, including patients presenting to the emergency department (ED) via ambulance, with acute chest pain or other symptoms suggestive of acute coronary syndrome (ACS), with an electrocardiogram (ECG) performed and interpreted before or within 10 minutes of arrival to ED.

Rationale:Help on this term

Early diagnosis optimises door-to-needle time and time to other interventions. The time taken to record the first ECG is a good index of quality care. The European Society of Cardiology guidelines identify that ECG should be performed within 10 minutes or less after the first medical contact (either on arrival of the patient in ED or at first contact with emergency medical services in the pre-hospital setting) and immediately interpreted by a qualified physician (Steg et al. 2012; Hamm et al. 2011).

Indicator set:Help on this term
Clinical care standard indicators: acute coronary syndromes

        Health, Standard 12/09/2016

Outcome area:Help on this term
Early assessment

        Health, Standard 12/09/2016

Collection and usage attributes

Computation description:Help on this term

Both the numerator and the denominator include patients with acute chest pain or other symptoms suggestive of ACS.

For hospitals collecting the Acute coronary syndrome (clinical) National best practice data set, the difference between the following data elements can provide the time within which ECG is performed:

  • Health service event—presentation date, DDMMYYYY combined with Health service event—presentation time, hhmm

and

  • Electrocardiogram—electrocardiogram date, DDMMYYYY combined with Electrocardiogram—electrocardiogram time, hhmm

Presented as a percentage.

Computation:Help on this term

(Numerator ÷ denominator) x 100

Numerator:Help on this term

Number of patients, including patients presenting to ED via ambulance, with acute chest pain or other symptoms suggestive of ACS, with ECG performed and interpreted before or within 10 minutes of arrival to ED.

Denominator:Help on this term

Number of patients presenting to ED, including via ambulance, with acute chest pain or other symptoms suggestive of ACS.

Comments:Help on this term

It is common practice for doctors and senior nursing staff to sign ECGs on review, with date and time of review.

Representational attributes

Representation class:Help on this termPercentage
Data type:Help on this termReal
Unit of measure:Help on this termService event
Format:Help on this term

N[NN]

Source and reference attributes

Reference documents:Help on this term

Hamm C et al. 2011. ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment-elevation. European Heart Journal 32:2999–3054.

Steg P et al. 2012. ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment-elevation. European Heart Journal 33:2569–2619.

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