spenac Posted May 14, 2008 Posted May 14, 2008 It varies. Some places do, some places don't. Some places rely on paramedic interpretation of the EKG, others rely on the machine interpretation. Machine interpretation is bad news as its almost always wrong in my experience. I can not believe that some services treat based on it.
EMS49393 Posted May 14, 2008 Posted May 14, 2008 The last service I worked for had the machine interpretation turned off on all the lifepaks. They taught 12 and 15 lead interpretation and held quarterly competencies. It was also required that the paramedic attach the ECG to a form and give the interpretation to complete documentation on the call. The service I currently work for states a 12 lead needs to be performed for any patient that may be a "cardiac patient" or has chest pain. It does not require the provider to be able to interpret the ECG, and the machine readings are provided (and more often than not, incorrect). We are required to attempt to send this 12-lead to the receiving hospital, however only a few hospitals actually have the capability to receive the ECG. There is no training on the 12-lead, no competencies, and we are only required to know if the ECG is "bad." Now, call me simple, but I would think a provider would have a hard time knowing if an ECG is "bad" when they have no idea what they are looking at. I know, way too logic for most services. My advice to new students and new paramedics... Know the heart. Know the ECG. Know to treat your patient, not your monitor. If your school doesn't teach the ECG in such a way that you are sure you know what you're looking at no matter what patient you have, your school sucks. Get a refund. Take the initiative to ask other providers, as our OP has done. Take the initiative to listen and act on our suggestions. Good luck OP, and if you need any more help in your quest for learning, let us know.
scott33 Posted May 15, 2008 Posted May 15, 2008 We definitely have only a cursory understanding of the heart...the CC program (mine especially) is heavily geared towards technician rather than clinician...here's a problem heres how we patch it in the field now go take the state test. That is probably the most mature and honest opinion of the CC course I have read. =D> Nothing worse than a CC, or an "I" who insist on proclaiming they are "just like medics". As for blocks, just review what they represent physiologically, and then go back and count boxes. Each block will follow a predictable pattern, whether regular in nature or not, so if you know the "rules" you will be fine. I know Dust will cringe at this, but think of the AV junction having a gatekeeper, allowing certain impulses through. It's not the best way to learn electrophysiology, but its a good way to pass your CC :wink: The Dubin book has been recommended by many paramedics for years, so I would get it if you don't already have it. Once you get the basics, and finish your course, you will have ample opportunity to build on what you have learned, with CMEs such as 12-lead EKG, capnometry, PALS, PEPP, PHTLS, AMLS, advanced airway, etc etc. Keep the learning up and you will be one of the better CCs out there.
Asysin2leads Posted May 15, 2008 Posted May 15, 2008 That is probably the most mature and honest opinion of the CC course I have re ad. =D> Nothing worse than a CC, or an "I" who insist on proclaiming they are "just like medics". As for blocks, just review what they represent physiologically, and then go back and count boxes. Each block will follow a predictable pattern, whether regular in nature or not, so if you know the "rules" you will be fine. I know Dust will cringe at this, but think of the AV junction having a gatekeeper, allowing certain impulses through. It's not the best way to learn electrophysiology, but its a good way to pass your CC :wink: The Dubin book has been recommended by many paramedics for years, so I would get it if you don't already have it. Once you get the basics, and finish your course, you will have ample opportunity to build on what you have learned, with CMEs such as 12-lead EKG, capnometry, PALS, PEPP, PHTLS, AMLS, advanced airway, etc etc. Keep the learning up and you will be one of the better CCs out there. Quit the course and put the time and effort into getting your paramedic. Do it. Right now. Thank me later.
EMSGeek Posted May 15, 2008 Author Posted May 15, 2008 I start my Paramedic in August. I am taking CC because I am able to work as an ALS tech while in the Paramedic program...more money and more options. The importance of paramedic vs CC is not lost on me. Thanks again guys for all the info.
spenac Posted May 15, 2008 Posted May 15, 2008 I start my Paramedic in August. I am taking CC because I am able to work as an ALS tech while in the Paramedic program...more money and more options. The importance of paramedic vs CC is not lost on me. Thanks again guys for all the info. Glad to hear it. Be prepared for many long hours of study and frustration. I'm hanging in there with my Paramedic studys but there are times I feel like walking away. But on here I see many others survive it so hopefully I do as well and I'm sure you will.
rock_shoes Posted May 15, 2008 Posted May 15, 2008 1. Buy this book... 2. Spend a week solid, working through the entire book at least twice. 3. Look at every strip you can get your hands on and never stop. End of story. You'll never have another problem with EKGs. You'll wonder why you even wasted your time in your cardiology class. Memorising patterns and rules is not cardiology. It's just monkey memory. That's the worst possible way to try to learn EKGs. And if that's what your CC school taught you, they should refund your money and be shut down for fraud. Good luck! Excellent book recommendation Dust. I checked it out online to see what it was all about and ordered it ten minutes later. It should be an excellent supplement to the cardiology section of my upcoming PCP course.
spenac Posted May 16, 2008 Posted May 16, 2008 Excellent book recommendation Dust. I checked it out online to see what it was all about and ordered it ten minutes later. It should be an excellent supplement to the cardiology section of my upcoming PCP course. I own it and swear by it. Best of the probably 20 EKG books I have.
Ridryder 911 Posted May 16, 2008 Posted May 16, 2008 Dubin's is one of the best Cardiology books around. Many physicians have learned the basics form his text... ironically he was not a Cardiologist (not to say anything of his past :shock: ). Nice to see that he finally focused upon EMS since we endorse his methods. For those that might review the text, don't be alarm by how simplistic it appears. It is actually written at a high degree, but the method used is unique. Like Dust described read a few times, let it cement itself in your cerebellum and then I suggest visiting an ICU/CCU and asking for any additional strips (tell them why you need them). Chances are that they will be able to provide you with hundreds of oddity strips..to review. It takes hundreds to thousands to master true ECG interpretation skills. Good luck! R/r 911
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