Motives for requesting an electrocardiogram in primary health care

Santos, Paulo; Martins, Carlos; Sá, Luísa; Hespanhol, Alberto; Couto, Luciana

doi:10.1590/1413-81232015205.10062014

Cited by 7 publications

(7 citation statements)

References 19 publications

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“…Electrocardiography in a primary health care setting is an effective tool which reduces the number of referral to specialist doctors. [ 10 11 ] Hence, in primary health care, similar straps can be made to overcome the difficulty of recording ECG on the hirsute chest and to avoid erythema on the site of electrode attachment. Precautionary, this strap can be used in known dermatographism patients to limit the exacerbation of symptoms due to application of suction-cup electrodes.…”

Section: Discussionmentioning

confidence: 99%

Fabrication of a low-cost strap for holding precordial electrodes on the hirsute chest

Mondal¹,

Chattopadhyay

Mondal

et al. 2020

J Family Med Prim Care

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Background: Reusable suction-cup electrodes are used for recording a 12-lead electrocardiogram (ECG) in resource-limited settings. These electrodes may easily detach if those are attached on a hirsute chest. Additionally, the suction pressure may cause erythema and pain. Aim: The aim of this study was to develop a low-cost strap for holding the suction-cup-based precordial electrodes and to test its applicability to the recording of ECG. Materials and Methods: A scrap rubber tube was cut in size so that it can cover all the precordial electrode positions. Slit openings (electrodes can be inserted through these opening) were made on this rubber strap. A cloth and a hook-and-loop fastener were used to make an adjustable fastener. ECG was recorded first on 16 non-hairy males with electrodes placed on the chest with the strap and then with electrodes attached by suction. After that, ECG was recorded on 16 males with hirsute chest first with the electrodes placed with the help of the strap and then with suction (without strap) on the shaved chest. Results: The outcome of this study is a low-cost ECG chest strap for a hirsute chest. Both the negative and positive QRS voltages in six precordial leads recorded with electrodes placed with the strap were similar to that of suction-attached electrodes in both non-hairy and hirsute chest. Conclusion: Developed rubber chest strap can be made with minimal cost and expertise in any resource-limited settings. This would help in recording the ECG of a patient with a hirsute chest. This prototype strap has scope for further improvement.

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Section: Discussionmentioning

confidence: 99%

Fabrication of a low-cost strap for holding precordial electrodes on the hirsute chest

Mondal¹,

Chattopadhyay

Mondal

et al. 2020

J Family Med Prim Care

View full text Add to dashboard Cite

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“…5,17,19,[22][23][24] Although the introduction of clinical guidelines is positive in the sense of facilitating the review of the vast available evidence, which the great majority of the respondents consider important, the actual transference of this importance to the organization by the implementation of these guidelines is still not optimal in a significant number of services. 25,26 The majority of the respondents appear to have enough knowledge to orient themselves and seek relevant scientific studies. Nevertheless, they do not seem familiar with the classic concepts of study subtypes.…”

Section: Discussionmentioning

confidence: 99%

Information Sources and Decision-Making in Neurosurgery: Results of a Survey of Members of the Brazilian Neurosurgery Society

et al. 2018

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Introduction In all surgical disciplines, including neurosurgery, there are questions about the level of evidence supporting surgical practices and the mechanisms and adequacy of knowledge translation. Objectives To assess the perception of Brazilian neurosurgeons of information sources and decision-making mechanisms related to their medical practices. Methods An online questionnaire was sent to the 2,400 members of the Brazilian Neurosurgical Society. Results A total of 32% of the neurosurgeons completed the questionnaire, 53% had more than 10 years experience, 67% had worked in public hospitals, 34% had performed spine surgeries, and 30% had performed brain tumor surgeries. The therapeutic decisions were based mostly on internship learning (54%) and personal professional experience (52%). The most common information sources were scientific abstracts (53%) and the Internet (47%). A total of 89% believed that evidence-based medicine was relevant, 93% believed protocols or guidelines were necessary, and 74% subscribed to a medical journal. Nonetheless, only 43% had protocols implemented in their services, 93% highly valued a surgeon's personal experience, and 63% showed little familiarity with the interpretation of scientific concepts in the literature. Among the respondents, 83% were willing to try an innovative treatment alternative if it was shown to improve clinical outcomes and reduce severe complications. Conclusions The disparity in the responses highlights the need to implement recommendations that improve decision-making mechanisms.

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“…poses in cardiovascular risk management (CVRM) [1]. Yet, the value of the ECG in primary care has been a recurrent topic of debate, above all in the context of CVRM [1][2][3][4][5][6][7][8][9][10][11]. The numbers needed to screen (NNS) for major outcomes have been reported to be 260 to prevent one death and 70 to find one case of coronary heart disease [2,5,12].…”

Section: Houten 2020mentioning

confidence: 99%

“…Poorly justified indications and misinterpretations, may lead to inappropriate patient management [13,14]. Guidelines acknowledge the limited benefit of an ECG in cardiovascular risk assessment except for suspected atrial fibrillation or therapy-resistant hypertension; yet, clear guidelines on the use of ECGs in primary care settings are not available [1,[15][16][17][18][19][20][21][22].…”

Section: Houten 2020mentioning

confidence: 99%

Interpretations of and management actions following ECGs in programmatic cardiovascular care in primary care: A retrospective dossier study

et al. 2020

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Background The usefulness of routine electrocardiograms (ECGs) in cardiovascular risk management (CVRM) and diabetes care is doubted. Objectives To assess the performance of general practitioners (GPs) in embedding ECGs in CVRM and diabetes care. Methods We collected 852 ECGs recorded by 20 GPs (12 practices) in the context of CVRM and diabetes care. Of all abnormal (n = 265) and a sample of the normal (n = 35) ECGs, data on the indications, interpretations and management actions were extracted from the corresponding medical records. An expert panel consisting of one cardiologist and one expert GP reviewed these 300 ECG cases. Results GPs found new abnormalities in 13.0% of all 852 ECGs (12.0% in routinely recorded ECGs versus 24.3% in ECGs performed for a specific indication). Management actions followed more often after ECGs performed for specific indications (17.6%) than after routine ECGs (6.0%). The expert panel agreed with the GPs' interpretations in 67% of the 300 assessed cases. Most often misinterpreted relevant ECG abnormalities were previous myocardial infarction, R-wave abnormalities and typical/atypical ST-segment and T-wave (ST-T) abnormalities. Agreement on patient management between GP and expert panel was 74%. Dis-Electronic supplementary material The online version of this article (

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Motives for requesting an electrocardiogram in primary health care

Cited by 7 publications

References 19 publications

Fabrication of a low-cost strap for holding precordial electrodes on the hirsute chest

Fabrication of a low-cost strap for holding precordial electrodes on the hirsute chest

Information Sources and Decision-Making in Neurosurgery: Results of a Survey of Members of the Brazilian Neurosurgery Society

Interpretations of and management actions following ECGs in programmatic cardiovascular care in primary care: A retrospective dossier study

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