Authors (including presenting author) :
Leung WY, Chan Y W, William, Lai S O
Affiliation :
Accident & Emergency department, Pok Oi Hospital
Accident & Emergency department, Tuen Mun Hospital
Accident & Emergency department, Tin Shui Wai Hospital
Introduction :
Triage is the initial assessment for patients in emergency department (ED). Timely recognition of chest pain and prompt acquisition of electrocardiogram (ECG) for ST-elevation myocardial infarction (STEMI) are crucial, as they are associated with earlier percutaneous coronary intervention (PCI) and improved patient outcomes. In the Accident and Emergency departments (AEDs) of New Territories West Cluster (NTWC) hospitals, including Tuen Mun Hospital, Pok Oi Hospital and Tin Shui Wai Hospital, ECG will be performed on all patients presenting with chest pain.
Objectives :
This study aims to review the door-to-ECG (DTE) time for STEMI patients in NTWC AEDs, specifically focusing on achieving DTE time within 20 minutes. We will also assess the key performance indicator (KPI) of door-to-triage times of less than 10 minutes, in accordance with American Heart Association guidelines, which recommend obtaining ECGs for all chest pain patients within this timeframe. Additionally, we will review patients' medical histories to identify risk factors.
Methodology :
We conducted a retrospective data collection from the databases of the three AEDs for STEMI cases from 1st January 2024 to 31st December 2024. A total of 349 clinical records were reviewed, focusing on DTE time and past health.
Result & Outcome :
The study sample included 349 patients, predominantly male (85.7%) and aged between 16 and 93 years old. The high-risk age group was identified between 50-59 and 60-69 years old. The most common past health risk factors included hypertension (31.8%), hyperlipidemia (20.3%), and diabetes mellitus (16.4%). The DTE time less than 20 minutes is 82.8% and less than 10 minutes is 56.7%. DTE time more than 20 minutes most due to not present of chest pain. Some cases presented with chest wall pain, epigastric pain or abdominal pain. A few cases were under triage that delayed the DTE time.
