Acquiring and interpreting a 12-lead ECG â from the standpoint of a paramedic â is certainly a high-frequency, and even the occasional high-acuity, event.
Even at the BLS/EMT level, acquiring a 12-lead ECG is becoming a common skill in many states.
So, how can we master this valuable, care-directing and diagnostic-quality skill? Practice, test and reference often.
Name that ECG rhythm
Practice doesnât always equate to perfection, but it does equate to quantity.
Any initial paramedic program should have a built-in, extensive, elaborate and comprehensive ECG rhythm and 12-lead (and even 15- and 18-lead) interpretation component throughout its course.
New paramedic students should get their eyes on, and interpret, hundreds of ECGs â and I mean hundreds!
Itâs all about exposure and building a âpatternâ to how you interpret your ECG. Creating a step-by-step process to how you tackle this data is imperative at an early stage in the game (and under the controlled environment of a classroom, too!).
Validate your strengths, identify your weaknesses
Testing doesnât always need to have the punitive component that we associate with it; it can be a valuable evaluation or assessment tool. It can provide validation and help identify areas for improvement.
After learning a new fact, skill, procedure, protocol or calculation, the only way that we can validate that the student has actually retained the information is to test them. This may occur through formal evaluation or informal observation but, in any event, testing is a necessary component of learning.
Paper still has its place in the testing world (or âevaluation worldâ â if you prefer). New to the market, however, are great electronic options that can be utilized via phone apps, online learning management systems and even via internal agency programs.
The end result of any learning process is to strive toward mastery. ECG acquisition and interpretation shouldnât be a novice-level skill for paramedic providers â we need to become masters at it! The only way that we can validate this is through testing.
Use a 12-lead reference
Amongst the many (or few) calls that you respond to each year are respiratory complaints, traumatic injuries, coughs and colds, strokes, lift assists and the occasional cardiac event. Having said that, paramedics arenât cardiologists, but that doesnât mean we shouldnât be able to speak their language!
For the complex cases, the atypical presentations and the funky-looking rhythms that you come across, having access to some form of reference can be a very valuable tool.
Interpretation apps can help to pinpoint the nuances of Sgarbossaâs criteria. A reference card can help to identify Takotsubo cardiomyopathy. A chart can help break down the differences between ventricular tachycardia and SVT with aberrancy.
If you donât commit this information into memory (and no one necessarily says that you should), then invest in a reference guide that can help you recall it in the middle of the night. We use references with pediatric medication doses, why not use them with complex ECG interpretation?
