Document Detail


Electrocardiogram interpretation in general practice: relevance to prehospital thrombolysis.
MedLine Citation:
PMID:  8398491     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To assess, in the context of their possible role in prehospital thrombolysis, the ability of general practitioners to recognise acute transmural myocardial ischaemia/infarction on an electrocardiogram. DESIGN: 150 doctors (every fifth name) were selected from the alphabetical list of 750 on Merseyside general practitioner register and without prior warning were asked to interpret a series of six 12 lead electrocardiograms. Three of these showed acute transmural ischaemia/infarction, one was normal, and two showed non-acute abnormalities. Details of doctors' ages, postgraduate training, and clinical practice were sought. SETTING: General practitioners' surgeries and postgraduate centres within the Merseyside area. PARTICIPANTS: 106 general practitioners (mean age 45 years) agreed to participate. MAIN OUTCOME MEASURE: Accuracy of general practitioners' interpretations of the six electrocardiograms. RESULTS: 82% of general practitioners correctly recognised a normal electrocardiogram. Recognition of acute abnormalities was less reliable. Between 33% and 61% correctly identified acute transmural ischaemia/infarction depending on the specific trace presented. Accurate localisation of the site of the infarct was achieved only by between 8% and 30% of participants, while between 22% and 25% correctly interpreted non-acute abnormalities. Neither routine use of electrocardiography nor postgraduate hospital experience in general medicine was associated with significantly greater expertise. CONCLUSION: The current level of proficiency of a sample of general practitioners in the Merseyside area in recognising acute transmural ischaemia/infarction on an electrocardiogram suggests that refresher training is needed if general practitioners are to give prehospital thrombolysis.
Authors:
W A McCrea; S Saltissi
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  British heart journal     Volume:  70     ISSN:  0007-0769     ISO Abbreviation:  Br Heart J     Publication Date:  1993 Sep 
Date Detail:
Created Date:  1993-11-17     Completed Date:  1993-11-17     Revised Date:  2010-03-24    
Medline Journal Info:
Nlm Unique ID:  0370634     Medline TA:  Br Heart J     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  219-25     Citation Subset:  AIM; IM    
Affiliation:
Department of Cardiology, Royal Liverpool Hospital.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Clinical Competence*
Electrocardiography*
Emergencies
Family Practice*
Humans
Middle Aged
Myocardial Infarction / diagnosis*
Thrombolytic Therapy
Time Factors
Comments/Corrections
Comment In:
Br Heart J. 1993 Sep;70(3):218   [PMID:  8398490 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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