Readyems.tumblr.com Website Review

i’ve had countless sessions and lectures on ecgs. i don’t know how many websites i have bookmarked, or how many times my eyes glazed over reading dubin. i’m also terrible at cardiology. i was on my way to accepting my fate of being horrible at ecgs forever, until i had a life changing session on ecgs taught by a great er doc. i want to post it here because it was probably the most useful thing i learned in med school, and it will stick with me for the rest of my career.  1. one ecg is never enough. always get old ones for comparison. if none available, do another one. because. one ecg is never enough.  2. rate. look at the number on top of the printed ecg. it’s stupid not to use that number. yes, you should know the rule, 300-150-100-75-60-50. people say you shouldn’t trust the machine because… well, it’s a machine, and it can make mistakes. this is true. i don’t like to look at their “diagnosis” until i have gone through it myself. but the rate is just a number. plus you should be able to eyeball it and be able to tell if it’s tachy, brady, etc. if the machine is telling you it’s 200 and if it looks tachy, then 3. rhythm. is there a p-wave for every qrs and a qrs for every p-wave? is the p-wave upright in lead ii and down in avr? good. done. boom. 4. axis. again, look at the number at the top of the page. if it’s between 0 and +90, then it’s normal axis. if the number isn’t complex disas*ociation. i sometimes get this and 2nd deg type ii mixed up. the only difference i try to remember is that pr interval is i literally go through this list of 11 points in my head when i’m reading an ecg, regardless of whether or not i have an atrial flutter jumping at my face or if i see a mas*ive anterolateral stemi. obviously i needed background knowledge on ecgs and the physiology of the heart before constructing this list, but this basic checklist has been very, very useful to me so far. it might look lengthy, but it doesn’t take a lot of time at all- a patient is not likely going to have all these issues with their heart.