Accuracy of ECG Interpretation in the Pediatric Emergency Department

Wathen, Joe E.; Rewers, Arleta B.; Yetman, Anji T.; Schaffer, Michael S.

doi:10.1016/j.annemergmed.2005.03.013

Cited by 36 publications

(32 citation statements)

References 4 publications

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“…The most common indications include the evaluation of chest pain, workup for possible dysrhythmia, evaluation of an acute episode (i.e., syncope), or toxicology workup after ingestion. In a review of over 1600 ECGs obtained at a pediatric ED, the most common indications were chest pain (21%), seizure or syncope evaluation (18%), dysrhythmia evaluation (17%), respi- ratory event or apparent life-threatening event (16%), ingestion or toxicologic evaluation (10%), and other cardiac evaluation (10%) (2). Although the great majority of ECGs in the pediatric population are normal, a significant percentage, as high as 20%, demonstrate significant abnormality (1).…”

Section: Approach To the Pediatric Ecgmentioning

confidence: 99%

Electrocardiographic Manifestations: Pediatric ECG

Chan

Sharieff

Brady

2008

The Journal of Emergency Medicine

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Section: Approach To the Pediatric Ecgmentioning

confidence: 99%

Electrocardiographic Manifestations: Pediatric ECG

Chan

Sharieff

Brady

2008

The Journal of Emergency Medicine

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“…Wathen et al 469 found an 87% concordance rate between emergency room pediatri cians and pediatric cardiologists. However, in exam ining accuracy rates with pediatric residents, Snyder et al 470 demonstrated no difference between senior pediatric residents and interns, with complex arrhyth mias being correctly interpreted only 28% (interns) to 45% (pediatric residents) of the time.…”

Section: Education Of Staffmentioning

confidence: 99%

Update to Practice Standards for Electrocardiographic Monitoring in Hospital Settings: A Scientific Statement From the American Heart Association

Sandau¹,

Funk²,

Auerbach³

et al. 2017

Circulation

206

214

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Background and Purpose: This scientific statement provides an interprofessional, comprehensive review of evidence and recommendations for indications, duration, and implementation of continuous electro cardiographic monitoring of hospitalized patients. Since the original practice standards were published in 2004, new issues have emerged that need to be addressed: overuse of arrhythmia monitoring among a variety of patient populations, appropriate use of ischemia and QT-interval monitoring among select populations, alarm management, and documentation in electronic health records. Methods: Authors were commissioned by the American Heart Association and included experts from general cardiology, electrophysiology (adult and pediatric), and interventional cardiology, as well as a hospitalist and experts in alarm management. Strict adherence to the American Heart Association conflict of interest policy was maintained throughout the consensus process. Authors were assigned topics relevant to their areas of expertise, reviewed the literature with an emphasis on publications since the prior practice standards, and drafted recommendations on indications and duration for electrocardiographic monitoring in accordance with the American Heart Association Level of Evidence grading algorithm that was in place at the time of commissioning. Results: The comprehensive document is grouped into 5 sections: (1) Overview of Arrhythmia, Ischemia, and QTc Monitoring; (2) Recommendations for Indication and Duration of Electrocardiographic Monitoring presented by patient population; (3) Organizational Aspects: Alarm Management, Education of Staff, and Documentation; (4) Implementation of Practice Standards; and (5) Call for Research. Conclusions: Many of the recommendations are based on limited data, so authors conclude with specific questions for further research.

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“…It would be inconceivable to become an internist without demonstrating some proficiency in ECG interpretation, and in fact, this is specifically addressed in the cardiology and internal medicine fields [25][26][27][28][29][30][31][32]. Not so for EEGs.…”

Section: Editorialmentioning

confidence: 99%

“…Unfortunately, the only existing American Academy of Neurology guidelines related to EEG are on esoteric or clinically irrelevant topics, such as quantitative EEG (1997 and 2003), and the EEG in the evaluation of headaches (1995). The American College of Cardiology works together with the American Society of Internal Medicine, the American College of Physicians and the American Academy of Emergency Medicine to raise standards for ECG [25][26][27][28][29][30][31][32]. Our professional organizations (American Academy of Neurology, American Epilepsy Society, American Clinical Neurophysiology Society) should address this politically difficult situation and work together to raise standards in EEG, in the interest of our patients.…”

Section: Editorialmentioning

confidence: 99%