ECGs: don't shrink from ECGs: Part 1 – ECG interpretation made easy for psychiatrists

With care of the mentally unwell our primary job (and many of us psychiatrists), we may wonder why we should be re-learning something that is essentially a medical skill that should be left to the medics.

But we must remember:

• psychiatric patients have significantly more comorbid medical illnesses AND have higher mortality rates as a result of this (Waddington et al, 1998),
• we use some of the most dangerous drugs on our patients – these increase the risk of sudden cardiac arrythmias and thus, sudden cardiac death (Ray et al, 2001),
• ECG interpretation is a basic skill expected of any UK medical school graduate, however studies show a lack of elementary knowledge of ECGs amongst all doctors (Montgomery et al, 1994),
• there is compelling evidence that ECG interpretation amongst psychiatrists is poor (Solomons et al, 2008),
• machine interpretation is not proven to be reliable (Willems et al, 1991).

The aim of this two-part module therefore is to refresh clinicians’ knowledge of ECGs and to help them recognise basic abnormalities, focusing on conditions that are most commonly seen in mentally unwell patients.