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Competence of psychiatric clinicians in interpreting electrocardiograms and QT intervals: can they do this? Does it matter?

  • Luke Solomons (a1), Adrian Treloar (a2) and Ryan Noronha (a3)
Abstract
Aims and Method

We assessed the abilities of trainee and consultant psychiatrists in reading and interpreting electrocardiograms (ECGs) and QT intervals using a questionnaire and standardised ECG.

Results

Only 5% of our sample of trainee and consultant psychiatrists could correctly indicate a QTc interval. Performances on other measures, such as rate were also poor, with senior house officers performing better than consultants.

Clinical Implications

The increased awareness of problems caused by antipsychotics has not been reflected in improved knowledge of ECGs among psychiatrists. Machines do not reliably calculate QT intervals. We therefore urge better training and understanding of ECGs for psychiatrists.

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Copyright
This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
References
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BJPsych Bulletin
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  • EISSN: 1472-1473
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Competence of psychiatric clinicians in interpreting electrocardiograms and QT intervals: can they do this? Does it matter?

  • Luke Solomons (a1), Adrian Treloar (a2) and Ryan Noronha (a3)
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eLetters

The heart of the matter

Adeniyi S Adetoki, Trainee Psychiatrist
04 September 2008

This article further highlights the fact that there is need for Psychiatrists to update skills in aspects of patient management that are perceived to be more related to specialties other than Psychiatry.

Mandatory training for trainees in Psychiatry already includes cardiopulmonary resuscitation (Immediate Life- saving Skills). I believe that adding ECG training to this will serve the purpose at least in the short term of equipping trainees with the skills needed to correctly interprete ECG tracings, perhaps with an emphasis on the QTc.

A point to bear in mind though is where the line is to be drawn, within the current litigious milieu of medical practice, regarding who interprets the result of an investigation.

The heart of the matter is this; ultimately, the Royal College will probably need to take a decision regarding the relevance or importance of Psychiatry trainees spending some time, as part of their training, in other Departments outside Psychiatry. This is with a view to addressing real or perceived inadequacies in skills and competency where issues such as the interpretation of ECGs, U & Es and CTs (to give a few examples)are concerned.

Declaration of interests: none.
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Conflict of interest: None Declared

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