Contact Person: Vincent Laurence Hamonangan Simanjuntak

mail : vincentlaurence@rocketmail.com
phone : 08123-145-8000

ABSTRACT

ST elevation in lead augmented Vector Right, do emergency room doctors notice?

a forgotten lead.
Simanjuntak, Vincent. L. H, MD.

General Practitioner, Hanau Region Public Hospital, Central Kalimantan, Indonesia.

Background: Acute Myocardial Infarction is a condition that needs rapid and proper intervention
managements, a good knowledge to diagnose and to select appropriate treatment options rests solely on
the correct identification of ST Elevation based on ECG reading skill by the emergency physician, such as
detecting ST elevation in lead aVR, including lead V1 or aVL, and/or diffuse ST depresion on precordial
leads, are tell tale sign of on going process of LMCA or proximal LAD occlusion, or triple vessels disease.
the confusion to identify the ECG findings, diagnose and treat the patient as either STEMI or NSTEMI
may lead to further delay in the proper treatment when the complete resources of treatment are available.

Objective: The objectives of this study were to find out; 1) the knowdge of ER doctor about aVR ST
elevation in ECG finding; 2) whether ER doctors are paying enough attention to the lead itself; 3) to
identify whether it had been taught during ACLS course as recalled by ER doctors.

Methods: This was a descriptive research using survey questionnaire approach, the samples were
obtained using simple random sampling methods, emergency room GP doctors, who have received valid
ACLS training in the last 3 years, which are serving around Indonesia, there are 60 doctors chosen as
samples, based on inclusion and exclusion criteria.

Results: The result of this research are; 1) 46.67% (28) of respondents have decend knowledge, while
43,34% (26) respondents have poor knowledge, and only 10% (6) of the respondents have good level of
knowledge; 2) only 16.7% (10) who actively paying attention to lead aVR; 3) only 6.7% (4) of ER doctors
who remembered having been taught of aVR STEMI.

Conclusion: The conclusion of this study are, ER doctors mostly have decend knowledge about aVR ST
elevation, however almost half of the samples have poor knowledge, only few ER doctors are actually
paying attention to lead aVR for ischemic finding, and most ER doctor do not receive training of aVR
STEMI during ACLS.

Keywords: level of knowledge, aVR, general physician, emergency room, ACLS.