Do Emergency Physicians Activate the Cath Lab Appropriately?

One of the recommendations to reduce door-to-balloon time for patients undergoing emergent percutaneous coronary intervention (PCI) is for emergency physicians (EPs) to activate the catheterization lab based on their assessment of patients and interpretation of electrocardiograms (ECGs).

As part of a quality assurance project at a tertiary-care academic hospital where primary PCI was performed for patients with ST-segment-elevation myocardial infarction (STEMI), the accuracy of 249 consecutive cath lab activations by EPs during a 27-month period was assessed, based on two cardiologists' independent reviews of ECGs. Cases were broadly categorized into three groups: true STEMI (76%), appropriate false-positive cath lab activation (19%), and un…