Abstract：
OBJECTIVE: The prompt recording of the electrocardiogram (ECG) and its correct interpretation is crucial to the management of patients who present to the emergency department (ED) with cardiovascular symptoms. Since triage nurses represent the first healthcare professionals evaluating the patient, improving their ability in interpreting the ECG could have a positive impact on clinical management. This real-world study investigates whether triage nurses can accurately interpret the ECG in patients presenting with cardiovascular symptoms.
METHODS: Prospective, single-centre observational study conducted in a general ED of General Hospital of Merano in Italy.
METHODS: For all patients included, the triage nurses and the emergency physicians were asked to independently interpret and classify the ECGs answering to dichotomous questions. We correlated the interpretation of the ECG made by the triage nurses with the occurrence of acute cardiovascular events. The inter-rater agreement in ECG interpretation between physicians and triage nurses was evaluated with Cohen\'s kappa analysis.
RESULTS: Four hundred and ninety-one patients were included. The inter-rater agreement between triage nurses and physicians in classifying an ECG as abnormal was good. Patients who developed an acute cardiovascular event were 10.6% (52/491), and in 84.6% (44/52) of them, the nurse accurately classified the ECG as abnormal, with a sensitivity of 84.6% and a specificity of 43.5%.
CONCLUSIONS: Triage nurses have a moderate ability in identifying alterations in specific components of the ECG but a good ability in identifying patterns indicative of time-dependent conditions correlated with major acute cardiovascular events.
UNASSIGNED: Triage nurses can accurately interpret the ECG in the ED to identify patients at high risk of acute cardiovascular events.
UNASSIGNED: The study was reported according to the STROBE guidelines.
UNASSIGNED: The study did not involve any patients during its conduction.
METHODS: Prospective, single-centre observational study conducted in a general ED of General Hospital of Merano in Italy.
METHODS: For all patients included, the triage nurses and the emergency physicians were asked to independently interpret and classify the ECGs answering to dichotomous questions. We correlated the interpretation of the ECG made by the triage nurses with the occurrence of acute cardiovascular events. The inter-rater agreement in ECG interpretation between physicians and triage nurses was evaluated with Cohen\'s kappa analysis.
RESULTS: Four hundred and ninety-one patients were included. The inter-rater agreement between triage nurses and physicians in classifying an ECG as abnormal was good. Patients who developed an acute cardiovascular event were 10.6% (52/491), and in 84.6% (44/52) of them, the nurse accurately classified the ECG as abnormal, with a sensitivity of 84.6% and a specificity of 43.5%.
CONCLUSIONS: Triage nurses have a moderate ability in identifying alterations in specific components of the ECG but a good ability in identifying patterns indicative of time-dependent conditions correlated with major acute cardiovascular events.
UNASSIGNED: Triage nurses can accurately interpret the ECG in the ED to identify patients at high risk of acute cardiovascular events.
UNASSIGNED: The study was reported according to the STROBE guidelines.
UNASSIGNED: The study did not involve any patients during its conduction.
摘要：
目的：快速记录心电图（ECG）及其正确解释对于急诊（ED）出现心血管症状的患者的管理至关重要。由于分诊护士代表了第一批评估患者的医疗保健专业人员，提高他们解释心电图的能力可能对临床管理产生积极影响.这项现实世界的研究调查了分诊护士是否可以准确地解释患有心血管症状的患者的心电图。
方法：前瞻性，在意大利梅拉诺总医院的普通ED中进行的单中心观察性研究。
方法：对于所有纳入的患者，分诊护士和急诊医师被要求独立解释和分类回答二分法问题的心电图.我们将分诊护士对心电图的解释与急性心血管事件的发生相关联。使用Cohen的kappa分析评估了医生和分诊护士之间在ECG解释方面的评分者之间的一致性。
结果：纳入491例患者。分诊护士和医生之间在将ECG分类为异常时的评分者之间的协议很好。发生急性心血管事件的患者占10.6%（52/491），其中84.6%(44/52)，护士准确地将心电图分类为异常，敏感性为84.6%，特异性为43.5%。
结论：分诊护士在识别ECG特定成分变化方面具有中等能力，但在识别与主要急性心血管事件相关的时间依赖性疾病的模式方面具有良好能力。
UNASSIGNED：分诊护士可以准确地解释ED中的ECG，以识别处于急性心血管事件高风险的患者。
未经评估：该研究是根据STROBE指南报告的。
UNASSIGNED：该研究在其传导过程中未涉及任何患者。
方法：前瞻性，
方法：对于所有纳入的患者，
结果：纳入491例患者。
结论：分诊护士在识别ECG特定成分变化方面具有中等能力，但在识别与主要急性心血管事件相关的时间依赖性疾病的模式方面具有良好能力。
UNASSIGNED：分诊护士可以准确地解释ED中的ECG，以识别处于急性心血管事件高风险的患者。
未经评估：该研究是根据STROBE指南报告的。
UNASSIGNED：该研究在其传导过程中未涉及任何患者。
