Kcanno13

Hi. Feel free to email me, and I will call you. In my experience, it is more efficient to have one five minute phone call versus exchanging five emails over the course of two weeks LOL

Leave a message with your phone number and I can call you. My email is [email protected].

As a psychiatric nurse, it is very interesting to have the expertise of a CC RN. Thank you for explaining the difference between HR and pulse; I did not know the two could vary dramatically, but, anatomically speaking, your explanation makes sense

The first EKG w/ the pt in the seated position had a significant number of artifacts due to tremoring and positioning, so I repeated the EKG laying and the reading did not have any significant artifacts. The manual pulse was 56. The automatic vitals sign machine also recorded a pulse of 56. The day shift nurse got back to me and said they would have preferred to have been notified, but did not seem overly upset. She was also told to trust the EKG over a manual pulse when the pt has a dx of A-fibb. Moving forward, I will always alert the physician to an abnormal EKG, regardless of pt diagnosis/hx.

Yes, I am not super comfortable interpreting EKG's, but I can do basic interpretations. I had my charge nurse review the EKG as well, and he saw no outstanding abnormalities. No significant findings from pt assessment. O2 sat above 95% on RA, no c/o of fatigue, dizziness, SOB, chest pain, or palpitations. LOC x4. No abnormal breathing pattern or other signs of distress noted. Pt conversational throughout exam. I did the EKG in the wheelchair to minimize the pt's discomfort (she was obese and had extreme difficulty changing positions); however, now I understand that the seated position is likely to give faulty readouts.

But now I'm concerned that maybe my interpretation was wrong? Worst case scenario, if the pt was having paroxysmal a-fibb will the physician likely be upset that I didn't notify them (given that this is a known and treated condition)?

No, they did not appear to be

Yes. The one performed in the wheelchair had a lot of artifacts that made it difficult to read, so I redid the EKG while the pt was laying down. There were no ST elevations or other notable abnormalities beyond the heart rhythm, which the EKG read-out interpreted as A-fib. Manual pulse check did not confirm the BPM recorded on the EKG.

Hi. I was hoping to get other's perspectives on this clinical scenario. I assumed care of a pt from 3:30-7:30. During this time, I did a routine EKG on a pt. Pertinent background, the pt has a dx of A-fibb and is on Digoxin and Plavix. I initially conduct the EKG while the pt is sitting in her wheelchair as I thought it would be accurate as long as the leads had good contact w/ the skin. I do seperate EKG's which say the pt's heart rate is between 140 and 150 BPM. I take her pulse manually and it's 56 BPM and I wonder whether the EKG is accurate. Pt has no c/o at this time. I know A-fibb can be asymptomatic, but didnt expect a change in heart rate that quickly. I immediately take her vital signs w/ an automatic vitals sign machine and again her pulse is around 56. I repeat the EKG laying down and again her pulse is reading between 120 and 130 BPM. I decide the machine must be giving a faulty readout and ask night shift to retake her pulse in an hr. I did not hear anything from night shift, but today a nurse on day shift called to ask about the EKG in question. Now I'm wondering if I should have notified the dr? I'm also thinking that the machine may have been correct and she was having paroxysmal episodes of A-fibb? Conidering she has already been diagnosed w/ A-fibb and being treated for it, should I have noticed the on-call dr anyway? Thank you for taking the time to read and respond to my question.

Cassie RNccrn and Rower19, it might simplify things if you email me your questions directly. You can contact me at [email protected]. I check this email account multiple times a day.

* Refer to edited comment below

Hello, I tried to respond to your message, but I apparently do not have access to the private message option as a new member. Could you please send me your email?

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