ArticleCureus2025
Optimizing Electrocardiogram Procedures in the Emergency Management of Suspected Acute Coronary Syndrome: A Clinical Audit at Al Damar Teaching Hospital, Sudan.
Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
12 authors.
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No grant is acknowledged in the PubMed record.
Abstract
introductionAcute coronary syndrome (ACS) is a time-sensitive condition requiring prompt diagnosis and management. The 12-lead ECG is central to early identification and is to be conducted soon after emergency department (ED) presentation. However, adherence in resource-limited settings remains suboptimal. This audit aimed to evaluate and improve ECG acquisition, interpretation, and documentation at Al Damar Teaching Hospital in Sudan.
methodsA two-cycle clinical audit was conducted using American Heart Association (AHA) and American College of Cardiology (ACC) benchmarks. The first cycle (May to June 2024) identified baseline performance in ECG timeliness and quality. Interventions included staff education, visual reminders, and workflow optimization. The second cycle (October to November 2024) assessed the impact of these interventions. Data were collected via a structured checklist, and analysis was performed using SPSS Statistics version 25 (IBM Corp., Armonk, NY, USA) with significance set at p<0.05.
resultsA total of 46 patients were included (21 in the first cycle, 25 in the second). The proportion of patients receiving ECGs within 10 minutes increased from five (23.8%) to 25 (100%) (p<0.001), and the average time from arrival to ECG acquisition dropped by 88.7%. Interpretation time also improved significantly (69.8%, p=0.0001). Documentation quality improved for rhythm (10 (47.6%) to 21 (84%), p=0.003), rate (12 (57.1%) to 20 (80%), p=0.009), and ST-segment (16 (76.2%) to 24 (96%), p<0.00001), although documentation of PR interval, QRS complex, and axis declined. The proportion of patients diagnosed with ACS rose from 18 (85.7%) to 25 (100%).
conclusionTargeted, low-cost interventions significantly enhanced ECG processing efficiency and documentation quality in a resource-limited emergency department. These findings underscore the potential for structured audits to drive sustainable quality improvement in ACS care pathways across similar settings.
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