Psychiatric Bulletin (2009) 33: 377-380. doi: 10.1192/pb.bp.108.022368
© 2009 The Royal College of Psychiatrists
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Junior doctors’ knowledge and practice of electrocardiographic monitoring for high-risk patients receiving antipsychotic medications

Fai-ZaZa Darwiche, Specialist Registrar

Academic Department of Neuropsychiatry, St Thomas’ Hospital, London SE1 7EH, email: fdarwiche{at}doctors.org.uk

Shoaib Ugradar

FY1, Newham University Hospital, London

Trevor Turner, Clinical Director and Honorary Senior Lecturer

Royal London School of Medicine, Queen Mary University of London, and Consultant Psychiatrist, East London Foundation Trust

Declaration of interest

None.

AIMS AND METHOD

The risk of developing fatal tachyarrhythmias can increase in patients receiving antipsychotic medication. Two surveys were conducted, one to evaluate junior doctors’ knowledge of the QTc interval and the second to investigate the experience of electrocardiographic (ECG) monitoring among patients on four acute psychiatric wards.

RESULTS

The first survey revealed that junior doctors were lacking in knowledge regarding the QTc interval. The second revealed that ECG monitoring of high-risk patients was inadequate. Half of the high-risk patients who required an ECG were not given one, whereas 6% who did not require one still received this investigation.

CLINICAL IMPLICATIONS

There is a need to increase knowledge about the cardiac risk of antipsychotic medication on psychiatric wards. Following simple recommendations could improve clinical practice.