Proposed Topic (Most preferred): :
Clinical Safety and Quality Service I (Projects aiming to improve efficiency and effectiveness of care delivery to meet international standards)
Authors (including presenting author) :
CHAN YWW(1), Leung CY(1), Ko SY(1), Ha PK(1), Wong HT(1)
Affiliation :
(1) Accident & Emergency Department, Tuen Mun Hospital
Introduction :
ST-segment elevation myocardial infraction (STEMI) is a high mortality and morbidity condition where mortality rises with each passing minute. As a result, "time is myocardium" has driven initiatives to improve timely coordination of care from screening, through diagnosis to treatment.
Objectives :
The primary study outcome was Door-to-ECG (D2E)time and the secondary outcome was accuracy of triage category.
Methodology :
This was a one year retrospective study in TMH AED, the emergency care STEMI registry between January 1 2022 to Dec 31 20222. It was including 177 AED-diagnosed patient with STEMI, total 161 patients included in the study and 16 patients excluded. The excluded case includes complained diarrhea, short of breath, epigastric pain, abdominal pain, dizzy, sore throat, generalized joint pain, dysuria & AROU etc.
Result & Outcome :
The study found that, a median D2E time was 11 mins and a mean D2E was 12 mins, D2E time within 10 mins was 47% and D2E time within 20 mins was 88%.
Excluding the outliners, the triage accuracy (cat 1 to cat 3) were 97%.
In comparing the characteristics of patients triage category 1&2 versus category 3, there were no significant difference in dyslipidemia, hypertension, DM, heart disease, morning shift, evening shift and night shift.
Last but not the least, AEDs in Hong Kong are implemented eAED system and it should way forward of emergency nursing triage to the AI decision support triage and predictive model or evidence-based models of screening STEMI.
