An Electrocardiogram-Based Diagnosis of Coma

Simard, Camille; Schwartz, Blair Carl

doi:10.1016/j.amjmed.2019.04.020

Cited by 3 publications

(5 citation statements)

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“…Primary hospitals had low medical equipment configuration and poor medical environment. Electrocardiograph is the most easily available, the cheapest and the most important irreplaceable diagnostic tool in any medical place [2][3][4]. More and more primary medical units are equipped with an electrocardiograph, and more and more primary medical workers are qualified to perform an electrocardiographic examination for patients.…”

Section: Discussionmentioning

confidence: 99%

“…ECG is an important reference for diagnosis, prevention, and evaluation of diseases [2][3][4][5][6][7][8][9]. Accurate diagnosis is the prerequisite for effective treatment, and ECG can be used as an auxiliary reference for the diagnosis of many diseases, especially in primary medical units and pre-hospital emergency treatment where laboratory examination and other means are lacking [15][16][17].…”

Section: Discussionmentioning

confidence: 99%

“…ECG is a technique that records the patterns of depolarization and repolarization of cardiomyocyte electrical activity during each cardiac cycle [3]. Electrocardiographic abnormalities are frequently the first manifestation of arrhythmia, myocardial ischemia, myocardiopathy, electrolyte metabolism, poisoning and coma, especially serious life-threatening arrhythmia and other critical patients [2][3][4][5][6]. ECG is also used in preventive health care and is an important tool for screening people at high risk of sudden death [2,[6][7].…”

Section: Introductionmentioning

confidence: 99%

“…Electrocardiograph is still the most powerful examination tool in primary care hospitals [2,11]. Primary care medical workers can perform electrocardiographic examination for patients with chest pain, chest stufly, abnormal breathing, palpitations or dizziness at any time, diagnosing life-threatening diseases and informing the superior hospital through communication devices in a timely manner, so as to shorten the time of first-aid for life-threatening diseases, such as patients with ST-Elevation Myocardial Infarction (STMI) [2,[4][5][6]11]. Primary medical workers can also evaluate the condition assessment and health guidance of patients with chronic diseases, such as CHD, through electrocardiographic examination [6,11].…”

Section: Introductionmentioning

confidence: 99%

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Please pay attention to the competency of Chinese primary clinical medical workers in electrocardiogrophic interpretation skills

Gao

et al. 2019

Preprint

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Background: Improving the capacity of health care, disease diagnosis and treatment of primary medical workers was the key to hierarchical diagnosis and treatment services. Electrocardiogram (ECG) played an important role in the diagnosis of cardiac diseases and should be regarded as the most basic tool for primary clinical medical workers in China.Objectives: To investigate the competency of Chinese medical workers in electrocardiographic interpretation skills, especially in the primary care hospitals, to explore the insufficiency of electrocardiographic interpretation skills and the improvement methods.Methods: A cross-sectional questionnaire study was conducted via the internet from March to October 2019. The questionnaire consists of 6 parts: basic information, equipping with an electrocardiograph, operating electrocardiograph, receiving electrocardiographic theory, testing of electrocardiographic interpretation, and improving electrocardiographic interpretation skills.Results: The effective quantity of this questionnaire was 2307, with an effective rate of 96.57%. The overall reliability was α=0.895. There were no significant differences among primary, private and class-Ⅲ hospitals in the aspects of equipping with an electrocardiograph (χ2=3.794, 3.104, P 0.05), operating the electrocardiograph (χ2=1.857, P 0.05) and receiving electrocardiographic theoretical study (χ2=6.701, P 0.05). Medical workers in private and class-Ⅲ hospitals had a stronger interpretation competency of ECG, including common or life-threatening ECGs (P 0.01). The development of talent echelon in primary hospitals affected the electrocardiographic interpretation skills of medical workers (P 0.01). In primary hospitals, the age was mainly ≥ 40 years (79.0%), the education background was mainly bachelor and below degree (80.9%), the professional qualification was mainly physician assistant (58.6%) and primary physician (31.4%). The interpretation competency of ECG of medical workers in private or class-Ⅲ hospitals was higher than that in primary hospitals (P 0.05 or 0.01).Conclusions: In China, the examination of electrocardiograph had been popularized. Due to the unreasonable development of talent echelon in primary hospitals, the electrocardiographic interpretation skills of primary medical workers were worrying. We should improve Authors' contributions YLG, YHL, and JL contributed equally to this work, they conceived the study with YFC and STS commenting on the study design. CXW and YCL acquired the data from questionnaires and been as questionnaire online instructors. YLG, YHL, and CL conducted the statistical analysis and interpretation of the data. YY advised on the statistical analysis. YLG wrote the first draft with support from JL. All authors reviewed the manuscript and made critical changes for intellectual content. All authors read and approved the final manuscript.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Please pay attention to the competency of Chinese primary clinical medical workers in electrocardiogrophic interpretation skills

Gao

et al. 2019

Preprint

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“…As a consequence of this bioelectrical activity, variations in the skin’s electrical potential are produced, which can be measured with highly sensitive instruments known as electrocardiographs and electrodes placed at predefined points on the skin surface [ 4 , 5 , 6 ]. The recording of these potential differences is known as an electrocardiogram (ECG) and represents a clinical tool widely used by cardiologists in routine medical evaluations to determine the pathophysiological conditions of the patient [ 7 , 8 , 9 , 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

ECG Patient Simulator Based on Mathematical Models

Quiroz-Juárez

Rosales-Juárez

Jiménez-Ramírez

et al. 2022

Sensors

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In this work, we propose a versatile, low-cost, and tunable electronic device to generate realistic electrocardiogram (ECG) waveforms, capable of simulating ECG of patients within a wide range of possibilities. A visual analysis of the clinical ECG register provides the cardiologist with vital physiological information to determine the patient’s heart condition. Because of its clinical significance, there is a strong interest in algorithms and medical ECG measuring devices that acquire, preserve, and process ECG recordings with high fidelity. Bearing this in mind, the proposed electronic device is based on four different mathematical models describing macroscopic heartbeat dynamics with ordinary differential equations. Firstly, we produce full 12-lead ECG profiles by implementing a model comprising a network of heterogeneous oscillators. Then, we implement a discretized reaction–diffusion model in our electronic device to reproduce ECG waveforms from various rhythm disorders. Finally, in order to show the versatility and capabilities of our system, we include two additional models, a ring of three coupled oscillators and a model based on a quasiperiodic motion, which can reproduce a wide range of pathological conditions. With this, the proposed device can reproduce around thirty-two cardiac rhythms with the possibility of exploring different parameter values to simulate new arrhythmias with the same hardware. Our system, which is a hybrid analog–digital circuit, generates realistic ECG signals through digital-to-analog converters whose amplitudes and waveforms are controlled through an interactive and friendly graphic interface. Our ECG patient simulator arises as a promising platform for assessing the performance of electrocardiograph equipment and ECG signal processing software in clinical trials. Additionally the produced 12-lead profiles can be tested in patient monitoring systems.

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2020

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An Electrocardiogram-Based Diagnosis of Coma

Cited by 3 publications

References 3 publications

Please pay attention to the competency of Chinese primary clinical medical workers in electrocardiogrophic interpretation skills

Please pay attention to the competency of Chinese primary clinical medical workers in electrocardiogrophic interpretation skills

ECG Patient Simulator Based on Mathematical Models

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