État des lieux de la pratique de l'électrocardiogramme en médecine générale en Picardie

Abstract : Introduction: there is a lot of indications for the use of the electrocardiogram (ECG) in general medicine but it seems little practised. The objectives of this study were to evaluate the population performing the ECG, its prevalence, the follow-up of the recommendations, there interpretation and to study for those not performing ECG the brakes and their axes of improvement. Method: This was a descriptive, cross-sectional epidemiological study. It concerned general practitioners settled in Picardy. 620 doctors randomly selected were assessed by questionnaire. Results: 136 answered or 22% of respondents. The ECG was practiced by 38% of the population and in 18% of the cases more than once a week. The reasons for achievement in acute were rhythm disorder, chest pain, discomfort and finally ionic disorder. The non-acute reasons for achievement were the ECG for the certificate of non-contra-indication to sports practice, the follow-up of a chronic pathology, the reference ECG and the introduction of a treatment. Practitioners were confident of their interpretation in 65% of cases (p <0.05). Among practitioners unsure of their reading, 56% performed a proofreading (p <0.05). They used 33% of the time to the cardiologist. The brakes put forward were a lack of competence for reading, logistics, medico-legal risk, the financial aspect and the proximity of specialists. For 26% of non-ECG physicians it was not a general practice. Continuing education would motivate 44% of physicians (p <0.05), grants and assistance from a third party to carry out the act would not change habits. Teletransmission was of interest to one out of two physicians (p <0.05). Conclusion: the ECG was an examination practiced quite frequently by a little more than a third of general practitioners Picardy. The recommendations were followed. Interpretation was problematic for almost one in five practitioners. The limits to its realization were the doubts on the interpretation, the cost, the fear of the pursuits and the time-consuming aspect. Teletransmission could turn the tide for one out of every two doctors.
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Master Thesis
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Clément Robin. État des lieux de la pratique de l'électrocardiogramme en médecine générale en Picardie. Médecine humaine et pathologie. 2018. ⟨dumas-02051245⟩

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