Ever since EMT-B school I have loved EKG strips. Of course, as a “B”, they simply held one up and said, “This is a rhythm strip. Now, back to splinting…”
To me, the most interesting thing about EKGs, and 12-leads in particular – I blurted out, “Holy crap!” when reading about them – was how much information there was in a strip. EKG strips always seemed to be a “now” kind of thing. This is what is happening now. And just heart stuff. Not so. Holy crap.
Has the patient had a previous infarct? Look for Q waves. Oh, here’s a very low “T” wave – perhaps the patient has had diarrhea this week? Or, a patient has very peaked “T” waves – may be a kidney problem here as well.
So much cool stuff. The EKG, if we study it long enough, is almost a little Pocket Fisherman tool. Add in your basic vital information, heart rate and BP, and you have a pretty good start on patient status.
Now, in the field we can run 12-leads, but in the transport gig we have a Catch-22: Most patients, yes, do need a diagnostic 12-lead, and they get that at the facility. Bring it along with the paperwork, and for the 20 minute transport a 3-lead is fine for monitoring. The catch is, some patients are having inferior or lateral problems which may show up better on a 12 – but those are exactly the patients you don’t want to delay transporting.
A few medics may argue that placing a 12-lead isn’t all that time consuming. Not on a fresh patient. But when your patient has huge round electrodes all over them from their initial 911 transport; oblong green-and-silver tabs from the ED; a couple MORE greens added by the cardiologist who perhaps was pickier about the placement – there isn’t a lot of room for us to use our snap-on electrodes, and those tabs have to come off. This adds to the time, of course, but also it seems to me that the receiving facility might want to run EKG #2, as a comparison, and use those green tabs themselves to get exactly the same placement used for EKG #1.
All of which is to say that the EKGs I’ll be uploading will, for the most part, be 3-leads. What you’d see in the field on a Philips (which generated these) or an LP12. Also, I am really digging on the “Categories” options available in WordPress. So, here’s a new one, EKG. The thing about EKG strips is they tend to fade over time, so scanning them in is the only sensible way to keep ’em. I figure, “Why not share?”
So print ’em out, laminate ’em, and deal ’em if you wanna play EKG Go Fish.
“Got any a-fibs?”