Can novice physicians perform a high-quality record of a 12-lead electrocardiographic examination? Preliminary data

Rafał Czyż, Marcin Leśkiewicz, Patrycja Czyż, Beata Wudarczyk

Abstract


High-quality 12-lead electrocardiogram recording is one of the most important elements of the patient's physical examination, not only in the case of chest pain. Carelessness and inaccuracy in the method of placing the electrodes on the patient's body results in poor record quality which may affect the wrong therapeutic decisions and the possibility of exposing the patient of health or even life loss.
The aim of the study was to determine the reliability of ECG electrodes placement on the patient’s body by novice physicians.
The study group consisted of 53 novice physicians who carry out a postgraduate internship including 58% of female. Results were collected with the use of authorial and anonymous questionnaire where participants marked the correct position of all ECG electrodes.
The correct position of the V1 electrode in the fourth right intercostal space was identified by only 19% of the respondents. Additionally, V1 and V2 were often (37.7%) incorrectly placed parasternally in the right and left second intercostal spaces. Only 2% of the study participants knew the correct position of the V3R electrode. Only 23% of participants knew the correct location of V7 lead, 15% location of V8 and 17% of V9 electrode.
It is necessary to propagate the correct technique of performing a 12-lead electrocardiogram recording of the heart in group of novice physicians. More detailed and practical training is undoubtedly indicated. Critical review of training and education curricula is therefore recommended.

Keywords


12-lead ECG, Electrocardiogram, quality of care and outcomes, additional leads, right ventricle

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References


- Batchvarov V.N, Malik M, Camm A.J.: Incorrect electrode cable connection during electrocardiographic recording. Europace. 2007; 9 (11): 1081-90.

DOI: 10.1093/europace/eum198, indexed in Pubmed: 17932025.

- Peberdy M.A,, Ornato J.P.: Recognition of electrocardiographic lead misplacements. Am J Emerg Med. 1993; 11 (4): 403-5.

DOI: https://doi.org/10.1016/0735-6757(93)90177-D, indexed in Pubmed: 17932025.

- García-Niebla J, García P.L.: An unusual case of electrode misplacement: left arm and V(2) electrode reversal. J Electrocardiol. 2008; 41 (5): 380-1.

DOI: 10.1016/j.jelectrocard.2008.04.007, indexed in Pubmed: 18572182.

- Greenfield J.C. Jr.: A bad day for quality control: sequential misplacement of left arm and left leg electrodes. J Electrocardiol. 2008; 41 (1): 1-3.

DOI: 10.1016/j.jelectrocard.2007.07.017, indexed in Pubmed: 17727877.

- Wenger W, Kligfield P.: Variability of precordial electrode placement during routine electrocardiography. J Electrocardiol. 1996; 29: 179-84.

DOI: https://doi.org/10.1016/S0022-0736(96)80080-X, indexed in Pubmed: 8854328.

- Rajaganeshan R, Ludlam C.L, Francis D.P, et al.: Accuracy in ECG lead placement among technicians, nurses, general physicians and cardiologists. Int J Clin Pract. 2008; 62 (1): 65-70. , indexed in Pubmed: 17764456.

- Somers M.P, Brady W.J, Bateman D.C, et al.: Additional electrocardiographic leads in the ED chest pain patient: right ventricular and posterior leads. Am J Emerg Med. 2003; 21(7): 563-73.

DOI: https://doi.org/10.1016/j.ajem.2003.08.008, indexed in Pubmed: 14655239.

- Carley S.D.: Beyond the 12 lead: review of the use of additional leads for the early electrocardiographic diagnosis of acute myocardial infarction. Emerg Med (Fremantle). 2003; 15 (2): 143-54.

DOI: https://doi.org/10.1046/j.1442-2026.2003.00431.x, indexed in Pubmed: 12675624.

- Trägårdh E, Engblom H, Pahlm O.: How many ECG leads do we need? Cardiol Clin. 2006; 24 (3): 317-30.

DOI: 10.1016/j.ccl.2006.04.005, indexed in Pubmed: 16939826.

- Rautaharju P.M, Park L, Rautaharju F.S, Crow R.: A standardized procedure for locating and documenting ECG chest electrode positions: consideration of the effect of breast tissue on ECG amplitudes in women. J Electrocardiol. 1998; 31 (1): 17-29.

DOI: https://doi.org/10.1016/S0022-0736(98)90003-6, indexed in Pubmed: 9533374.

- Hill N.E, Goodman J.S.: Importance of accurate placement of precordial leads in the 12-lead electrocardiogram. Heart Lung. 1987; 16 (5): 561-6. Indexed in Pubmed: 3308780.




DOI: http://dx.doi.org/10.5281/zenodo.1406344

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