Published Apr 12, 2006
ljds
171 Posts
I'm an LPN, I work in a smallish hosiptal on the medical floor. last night I had a pt who experienced chest pain, (right at shift change! Argh!), and per our protocol I among other things called for a stat EKG. When it was finished, I took the print out and took the one from the day before (the guy was on tele, had a recent heart cath, and had a routine EKG the day before).
At the top of the print out there is usually a little summary, telling what the rhythm is. The one I had just got said afib; the one from the day before said s-tach with 1st degree avb. We always fax them over to the ICU where the tele monitors are. The ICu nurse told me that the EKGs were essentially unchanged. The tele strip also was unchanged, and he was still in SR/STACH.
WHen I called the doc, I told him what the ICU nurse had said. Now I'm second guessing myself, and feeling inadequate in the meantime. I want to read my own EKGs; but there aren't a whole lot of (read: rarely any) classes available in my area for this thing.
So, I want to know if you all on the med floors are expected to read your own EKGs, or if you fax them over to the tele/ICU nurses to read. What is your facility, as well as your personal expectation of this? My covering nurse was the charge nurse, and she is no better at EKGs than I am; none of us are. Before I called, I asked what the other nurses thought; they all trusted the ICU nurse, in part because her interpretation jived with the tele strip readings.
Where can I learn more about EKG interpretation? Do you have any recommended books or websites?
Thanks;
Lori
Barneymurch
3 Posts
Hi you could try the following website: www.skillstat.com to practice on. I believe it pays to get the EKG /ECG's checked out as the machines don't always read them correctly. So I think you did OK by asking for help/ advice on that occasion.
Cheers
Katnip, RN
2,904 Posts
Rapid Interpretation of EKG's by Dale Dubin.
It's great for newbies and for refreshing old timers. It's very basic, and literally holds your hand through every step of the way.
Thanks for your recommendations. I appreciate it!
suzanne4, RN
26,410 Posts
First, never, ever go by the reading at the top of the EKG. They are incorrect most of the time. Fastest way to check things out is to compare the new one and see if there are any differences in each of the leads.
There are also on-line EKG programs that you can sign up for and take. One I believe is thru www.RN.com.
TMPaul
195 Posts
I'm an LPN, I work in a smallish hosiptal on the medical floor. last night I had a pt who experienced chest pain, (right at shift change! Argh!), and per our protocol I among other things called for a stat EKG. When it was finished, I took the print out and took the one from the day before (the guy was on tele, had a recent heart cath, and had a routine EKG the day before). At the top of the print out there is usually a little summary, telling what the rhythm is. The one I had just got said afib; the one from the day before said s-tach with 1st degree avb. We always fax them over to the ICU where the tele monitors are. The ICu nurse told me that the EKGs were essentially unchanged. The tele strip also was unchanged, and he was still in SR/STACH.WHen I called the doc, I told him what the ICU nurse had said. Now I'm second guessing myself, and feeling inadequate in the meantime. I want to read my own EKGs; but there aren't a whole lot of (read: rarely any) classes available in my area for this thing.So, I want to know if you all on the med floors are expected to read your own EKGs, or if you fax them over to the tele/ICU nurses to read. What is your facility, as well as your personal expectation of this? My covering nurse was the charge nurse, and she is no better at EKGs than I am; none of us are. Before I called, I asked what the other nurses thought; they all trusted the ICU nurse, in part because her interpretation jived with the tele strip readings.Where can I learn more about EKG interpretation? Do you have any recommended books or websites?Thanks;Lori
I do read the EKG's on my patient but I always have my supervising MD (I am a Nurse Practitioner) review and I NEVER base my treatment solely on a EKG; look at your patient. :)
Thank you; this was my thought, as well; I am suspicious of an automated evaluation, and felt it was better to have the ICU nurse compare the EKGs and then also have her closely evaluate the tele strip (which is over in ICU). But the reading of afib threw me off--he didn't sound like he was in afib when I listened, his tele wasn't showing afib--but I'm new enough (I just started there 6 months ago--before I spent 4 years as an office nurse and midwife's assistant) to this area and job that I was doubting myself there. The man was in obvious distress, and I felt something was going on with him in a cardiovascular manner, but I just didn't feel like he was in afib.
Thanks for all the advice and suggestions. I appreciate it. You all are a great resource.
Jedi_Iatros
46 Posts
You need somebody like me to read them and DO the treatment at the same time![EVIL][/EVIL]