Reading a ekg

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Reading a ekg

Postby whatever » Thu Apr 19, 2012 2:03 pm

Ok so ever since the post we had awhile back about some examiner
saving someone's life
from having the ability to read a ekg, I have been trying to do a little self teaching.

My medical teaching only covered proper lead placement and a brief run down on ekg's, the setting I preformed ekg's in before becoming a PE there was always a MD standing close waiting for ekg, so I never really had a need to learn more.

I thought it might be interesting to start a post on little easy tricks that PE's might know about ekgs.

Easy pulse checker, count the number of R waves in a 6 second strip and multiply by 10 for example , if there are 7 R waves in a 6 second strip, the heart rate is around 70 (7x10=70).
Now most of our ekgs read the pulse for us I know, but I like to check myself and the machine.

How about pulse irregularities? Premature (extra) heartbeats, I was told the R wave will be noticeably wider with palpitations, so if you see this on a ekg and did not hear any irregularities on your 1 minute pulse it might be a good idea to recheck.
Pulses are funny, sometimes I think I might hear a irregularity and I will retake and not hear it the second time. I am sure we all face these things at some point and being alone in the field we don't have the luxury of having a extra pair of ears to say come listen to this.
Has anyone had someone's pulse so irregular that you had a hard time counting the irregularities? I have, and will generally just put a + in the box indicating something is not right with the pulse.

I had a applicant the other day whose BP was high, when I looked at the ekg I did notice the R waves in the v4 v5 v6 area were a little different then normal, could this confirm hbp to the MD who reads it?

Just putting a few things out there that I think about and wonder if others do.

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