jwb@ecsvax.UUCP (03/13/84)
With respect to the responsibility of a cardiologist to overread every ECG, this
is (or should be) uniformly done. The problem addressed by the dial up services
is that in the middle of the night, in a small town hospital, the cardiologist's
reading may not come until the next day. Many communities do not have a
cardiologist at all. The physician obtaining the ECG (who in an emergency room
is typically NOT a cardiologist) has an obligation to carefully examine the
ECG obtained. There are two schools of thought with regard to sending computer
ECG information to a physician who may not be expert in interpreting an ECG.
One is that any information is better than none, and therefore the nonexpert
physician should get the information. The other is that if there is a screw
up, and the local physician cannot be trusted to recognize this, the computer
analysis can do significant harm and should be witheld (The local physician
will ALWAYS have his own interpretation.) Both approaches have their merit.
Our local approach is to NOT send machine interpretations back to the Emergency
Room until a person with some expertise in reading ECG's has looked at the
tracing and at the computer generated interpretation. In some cases, this
approach negates the major advantage of having the computer in the first place.
(If this discussion does not belong in net.ai, then tell me and I'll shut up.
I have been responding to items as they come across, am currently reading this
using "A" news and, in this case, couldn't get the f command to work.)
Jack Buchanan
Cardiology and Biomedical Engineering
UNC-Chapel Hill
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