Intravenous beta-blockers in acute myocardial infarction: Perceived versus actual use by cardiologists and emergency physicians
| Autor: | John S. Banas, Martin M O'Bryan |
|---|---|
| Rok vydání: | 1998 |
| Předmět: |
medicine.medical_specialty
health care facilities manpower and services Adrenergic beta-Antagonists Decision Making Cardiology Myocardial Infarction Hospitals Community medicine Humans cardiovascular diseases Myocardial infarction Practice Patterns Physicians' Medical prescription Intensive care medicine Contraindication health care economics and organizations Retrospective Studies Actual use business.industry Contraindications Retrospective cohort study General Medicine Emergency department medicine.disease Drug Utilization United States Community hospital Blood pressure Injections Intravenous Emergency medicine Emergency Medicine Emergency Service Hospital business |
| Zdroj: | The American Journal of Emergency Medicine. 16:623-626 |
| ISSN: | 0735-6757 |
| DOI: | 10.1016/s0735-6757(98)90160-7 |
| Popis: | This study sought to determine the relationship between perceived and actual use of intravenous beta-blockers by cardiologists and emergency physicians for patients with acute myocardial infarction (AMI). The charts of 35 patients who presented to the emergency department of a community hospital with AMI during a 6-month period were retrospectively reviewed. Members of the departments of cardiology and emergency medicine were mailed a one-page survey pertaining to their use of intravenous beta-blockers in AMI. Of the 35 patients only 4 (11%) received an intravenous beta-blocker. Three of these 4 patients were either hypertensive or tachycardic and none had a contraindication to beta-blockade. A contraindication was present in 15 (48%) of those who did not get intravenous beta-blockade. The survey was completed by 11 (100%) of the emergency physicians and 68 (69%) of the cardiologists. Emergency physicians were significantly less likely to report using intravenous beta-blockers in AMI patients who were normotensive with normal heart rates (P=.007) and most (9 of 11) deferred the decision to the cardiologist. Although the majority of cardiologists reported giving an intravenous beta-blocker to at least 50% of AMI patients with normal blood pressure and pulse rates, the actual frequency was only 8% (1 of 13). In this institution, cardiologists overestimated the frequency of intravenous beta-blocker administration to patients with AMI. Emergency physicians usually deferred the decision on intravenous beta-blockers to cardiologists and reported a frequency of use that was much closer to actual practice. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect