Effect of emergency bell on door to ECG time in walk-in patients presented to emergency department with chest pain

Kim, Min-Woo; Oh, Sang-Hoon; Park, Kyu-Nam; Lee, Jung-Min; Lee, Young-Mee; Kim, Han-Joon; Kim, Soo-Hyun; Kang, Dong-Jae

doi:2014.20.1.12

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

Abstract

Objectives
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.
Methods
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.
Results
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.
Conclusion
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;