craig Posted March 1, 2012 Posted March 1, 2012 I love this new instructor. ST elevation in all leads... global MI? Nah... just pericarditis... (you really have to be here, but I never knew that before and I could totally see freaking out seeing ST elevation all over the place if I didn't realize it was pericarditis!) Wendy CO EMT-B Do get down about it wendy we did a 12 lead on me as an example for some of the guys that were training and they nearly sh*t themselves when they saw all the ST elevation ( I did when i first had a 12 lead done on my self) however the narrow QRS in V1 wasnt picked up by these guys and so they misdiagnosed a LBBB as suspected STEMI. Thats all the fun in training, you see and learn things that seem realy odd, but you never forget them... and the guys that did the 12 lead on me were reassured that they didnt have to rush me to the ER..........
celticcare Posted March 1, 2012 Posted March 1, 2012 Pulse checking is still in if it is in the hands of people who know what they are doing, and deal with codes and arrests etc on a more regular basis than some others in the nursing world. I still have some collegues wendy, that look at the ECG and you can see the colour drain from their face and the poop fill their pants and its down to simply, are they showing signs of an MI? Have you guys covered high take off yet? that still catches a few of my work mates out, but its experience and I was the same when I first started as a telemetry nurse on shift in CCU.
Kiwiology Posted March 1, 2012 Posted March 1, 2012 Pulse checking is still in if it is in the hands of people who know what they are doing, and deal with codes and arrests etc on a more regular basis than some others in the nursing world. Yeah, the new Clinical Practice Guidelines say you should check a pulse during the rhythm check if the rhythm looks capable of producing output I still have some collegues wendy, that look at the ECG and you can see the colour drain from their face and the poop fill their pants and its down to simply, are they showing signs of an MI? It annoys me greatly that most of our cohort have probably already forgotten the majority of what they are taught in terms of biomedical science We are taught basic arrhythmia recognition, recognising ST elevation and localising infarcts as well as some advanced arrhythmias e.g. heart block; as well as the cellular chemical basis of metabolism e.g. gluconeogenesis and oxidative phosphorylation and the electrochemical changes in membranes of excitable cells leading to depolarisation. Our biochemistry paper coordinator said she knows most people just remember it for the exam then forget it and never use such information in clinical practice. The same can be said for ECG interpretation. There are exceptions and I know many cardiac nurses who could probably leave the House Surgeon on his cardiac run for dead or diabetes nurses who can take glucose-1,6-bisphosphate and whop me over the head with it. I'm sure many emergency department nurses can spot a ischaemic changes on 12 lead ECG before the plaque has even deposited in the patient's vascular endothelial cells. when I first started as a telemetry nurse on shift in CCU. Now, now you just wanted to get some experience so you could move next door
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