[Evaluation of a support for the analysis of electrocardiogram by emergency residents]

Abstract

Aim: Electrocardiogram (ECG) is a routine examination in emergency medicine (EM), however the level of resident's interpretations is inhomogeneous and sometimes insufficient. We have developed a support to assist in the interpretation of ECG in emergency situations. Our main objective was to assess whether this new tool improved the rate of good interpretations by residents of EM departments (EMD). The secondary objectives were to assess whether it improved the rate of good triages, the level of certainty of residents, and to study its impact according to the seniority of the resident.

Patients and method: Multi-center, before-and-after study, carried out with existing residents in the different EMD dependent of a single university hospital center. The evaluation was conducted in two stages: an initial analysis of 17 ECGs without tool and a new analysis using the tool.

Results: Out of a target population of 68 residents, 41 (60 %) were included. The tool significantly improved the correct reading rate from 46 % without the tool to 68 % (P<0.001). The rate of correct triage (56 % vs. 64 %) and diagnostic certainty (54 vs. 66 on a scale of 0 to 100) were also significantly improved (P<0.001). The more experienced residents were generally more efficient in pre-testing, but the tool improved results regardless of seniority.

Conclusion: The development of a simple support to assist in the interpretation of ECGs improves the rate of good interpretations among residents in EMD.

Keywords: Electrocardiogram; Emergency medicine; Internes; Interpretation; Interprétation; Médecine d’urgence; Residents; Support; Tool; Électrocardiogramme.