At 12:25 10/03/2009, you wrote:
>ECG machines in general practice. Is this a good idea? What proportion of GP
>have these? Does anyone have comments or recommendations?
>
>Thanks.
>
>Laurie
Is it a good idea - generally yes.
Not known, but locally high (100% or thereabouts)
Self reporting in machines is a supplement, not a replacement for
good human interpretation.
The capacity to export from the machine straight into your PC is a bonus.
Those taking the ECGs will need training - and, aside from experience
as a GP, having had a few ECGs in a few different settings I can
vouch for the fact that not all training (eg degree of skin prep, as
well as lead positioning, breathing instructions etc) or all machines
produce the same results.
Now the contentious bits:
Avoid using to evaluate acute chest pain - once you consider a
cardiac cause or a PE possible, no ECG can exclude the diagnosis.
Those reporting the ECGs will need training - and at ECG quizzes many
GPs seem to be << 100% accurate, with accuracy INVERSELY proportional
to confidence.
They are good for example in rhythm assessment, LV hypertrophy eg in
hypertension, and unexpected abnormals in people who present with
vascular disease but no known Hx of MI.
However NOT a core service.
Best wishes,
Julian
|