INTERPRETATION OF THE EMERGENCY ELECTROCARDIOGRAM BY JUNIOR HOSPITAL DOCTORS

Objective-To assess the ability of a cohort of junior hospital doctors to interpret ECGs which have immediate clinical relevance and influen ce subsequent management of patients. Methods-57 junior hospital docto rs were interviewed and asked to complete a standard questionnaire whi ch included eight ECGs for interpretation and a supplementary question relating to the administration of thrombolytic treatment. Each doctor was assessed over a 48 h period while they performed their daily clin ical duties. Results-The major abnormality of anterior myocardial infa rction was recognised by almost all doctors. There was difficulty in t he interpretation of posterior myocardial infarction and second degree heart block. Most myocardial infarctions would have been given satisf actory thrombolysis, but there was a reluctance to use this treatment in patients with posterior myocardial infarction and left bundle brach block. A few patients without myocardial infarction would have receiv ed thrombolytic treatment. Conclusions-There is varying ability among junior hospital doctors in the interpretation of the emergency electro cardiogram. The results are of concern as poor interpretation of the E CG can result in inappropriate management. As a result of the findings of this study it is proposed to introduce more formal training in the interpretation of clinically relevant ECG abnormalities for junior ho spital doctors.