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Physician Attitudes About Prehospital 12-Lead ECGs in Chest Pain Patients

Published online by Cambridge University Press:  28 June 2012

Andrew H. Brainard ,
Philip Froman ,
Maria E. Alarcon ,
Bill Raynovich  and
Dan Tandberg
Andrew H. Brainard
Affiliation:
EMS Academy, University of New Mexico, Albuquerque, New Mexico
Philip Froman
Affiliation:
Medical Director, Albuquerque Ambulance Service, and Departmet of Emergency Medicine, University of New Mexico, Albuquerque, New Mexico
Maria E. Alarcon
Affiliation:
Department of Emergency Medicine, University of New Mexico, Albuquerque, New Mexico
Bill Raynovich*
Affiliation:
EMS Academy, University of New Mexico, Albuquerque, New Mexico
Dan Tandberg
Affiliation:
Department of Emergency Medicine, University of New Mexico, Albuquerque, New Mexico
*
EMS Academy, 2700 Yale Boulevard SE, Albuquerque, New Mexico 87106, USA E-mail: billr@unm.edu
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Abstract

Introduction:

The prehospital 12-lead electrocardiogram (ECG) has become a standard of care. For the prehospital 12-lead ECG to be useful clinically, however, cardiologists and emergency physicians (EP) must view the test as useful. This study measured physician attitudes about the prehospital 12-lead ECG.

Hypothesis:

This study tested the hypothesis that physicians had “no opinion” regarding the prehospital 12-lead ECG.

Methods:

An anonymous survey was conducted to measure EP and cardiologist attitudes toward prehospital 12-lead ECGs. Hypothesis tests against “no opinion” (VAS = 50 mm) were made with 95% confidence intervals (CIs), and intergroup comparisons were made with the Student-t-test.

Results:

Seventy-one of 87 (81.6%) surveys were returned. Twenty-five (67.6%) cardiologists responded and 45 (90%) EPs responded. Both groups of physicians viewed prehospital 12-lead ECGs as beneficial (mean = 69 mm; 95% CI = 65–74mm). All physicians perceived that ECGs positively influence preparation of staff (mean = 63 mm; 95% CI = 60–72mm) and that ECGs transmitted to hospitals would be beneficial (mean = 66 mm; 95% CI = 60–72mm). Cardiologists had more favorable opinions than did EPs. The ability of paramedics to interpret ECGs was not seen as important (mean = 50 mm; 95% CI = 43–56mm). The justifiable increase in field time was perceived to be 3.2 minutes (95% CI = 2.7–3.8 minutes), with 23 (32.8%) preferring that it be done on scene, 46 (65.7%) during transport, and one (1.4%) not at all.

Conclusions:

Prehospital 12-lead ECGs generally are perceived as worthwhile by cardiologists and EPs. Cardiologists have a higher opinion of the value and utility of field ECGs. Since the reduction in mortality from the 12-lead ECG is small, it is likely that positive physician attitudes are attributable to other factors.

Keywords

12-lead ECGadvance cardiac life supportacute myocardial infarctioncardiologyelectrocardiogramemergencyemergency physicianemergency medical servicesprehospitalreperfusionstandard of caresurvey
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 17 , Issue 1 , March 2002 , pp. 33 - 37
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2002

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