EKG help

What exactly are you having trouble with? One thing you have to consider is to always treat the patient and their symptoms, then bring the EKG into play. I work in PAT so we are frequently doing EKGs on patients and I look at them first before they are confirmed by a cardiologist the next day. One thing I always do if I get a crappy-looking EKG (and I don't mean one showing an acute MI - but maybe an old MI, poor R-wave progression, BBB, etc. and the patient does not have a previous cardiac hx. to support the current EKG tracing) is I call their doc's office to see if they have one on file there. It only takes a matter of minutes to have one faxed over to compare the two. Unfortunately, this might not be so easy if it's off-hours.

Can you shadow a cardiologist? You say ED is your background - could you look at a bunch of them with one of the ED docs and see what they do/how they treat with various EKGs? I would say that in an urgent care setting - if you get a person c/o chest discomfort, SOB, syncope, or any other various possible cardiac symptoms, etc. and the EKG is not obviously completely normal, then your best decision would be to transfer to a higher level of care - ie - the ED. Remember, even normal EKGs do not absolutely r/o a cardiac entity, so if there is any doubt, you do have that option to send to the ED. IMHO, it's always better to err on the side of caution.

Spacklehead,

I think I'm just not a 'picture' person. I don't like tables and graphs and such. Sometimes I will ask a MD questions, but most of the time we are just too busy. I think it just intimidates me...kind of like math LOL

I have an NP friend who worked cardio who will work with me. Once again, a matter of time, and coordinating schedules.

I used to work in PAT as an RN in an outpatient surgery center. What setting are you in? Definately something I would consider as an NP.

I work in a hospital setting. I do PAT as well as see patients in the same-day surgical unit who may not have come in for PAT prior to their procedure. I also do the H&Ps on patients who are admitted for emergency surgery like chole's and appy's.

I thoroughly enjoy it, but we are BUSY! Also, it can become a game of phone tag with the patients' PCPs when you have lab/X-ray/EKG results that are abnormal and medical clearance is warranted.

Good luck with the EKGs!

If it is something you will use often I highly suggest Necessary Workshops from Marye Dorsey Kellermann

Her cardiac review. I went in knowing buptkis, when I walked out I felt confident that I could correctly read a 12 lead and come up with a diagnosis. Unfortunately for me it was a very perishable skill.

Check it out.

I hope it helps. Good luck.