The frequency of electrocardiographic errors due to electrode cable switches: a before and after study
Thomas Thaler1, Volker Tempelmann, Marco Maggiorini
1Department of Cardiology, Canton Hospital Sankt Gallen, Rorschacher Strasse 95, Sankt Gallen, Switzerland.
Introduction:
Electrocardiographic (ECG) errors due to electrode cable reversal confuse physicians and provoke unnecessary diagnostic tests. They occur in approximately 4% of ECGs performed in the intensive care unit (ICU). We aimed to investigate whether this frequency could be reduced by an appropriate intervention.
Methods:
All ECGs from consecutive patients were collected at ICU discharge and analyzed by the investigators. Before collecting a second set of ECGs, we educated our ICU staff and performed technical improvements on the electrocardiographs (system approach). Electrocardiographic errors were identified applying previously published morphologic criteria.
Results:
We collected and analyzed 1123 ECGs from 416 patients. Nine hundred ten ECGs (81%) were recorded in the ICU; and the frequencies of electrode cable misplacements before and after the intervention were 4.8% and 1.2%, respectively (P = .002).
Conclusions:
Using a system approach, we were able to significantly reduce the frequency of ECG errors due to electrode cable switches by 75%.
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