Strip Poker

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?”

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One Response

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