Acute coronary syndromes: 2c-ECG performed within 10 minutes of arrival to the emergency department
Identifying and definitional attributes
|Metadata item type:||Indicator|
|Short name:||Indicator 2c-ECG performed within 10 minutes of arrival to the emergency department|
|Registration status:||Health, Standard 12/09/2016|
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.
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:||Clinical care standard indicators: acute coronary syndromes Health, Standard 12/09/2016|
|Outcome area:||Early assessment Health, Standard 12/09/2016|
Collection and usage attributes
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:
Presented as a percentage.
(Numerator ÷ denominator) x 100
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.
Number of patients presenting to ED, including via ambulance, with acute chest pain or other symptoms suggestive of ACS.
It is common practice for doctors and senior nursing staff to sign ECGs on review, with date and time of review.
|Unit of measure:||Service event|
Source and reference attributes
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.