ECG computer analysis
Started by sozme
D
da8s0859q
Look at, yes. Rely, never. Almost always accurate for interval measurements and whatnot, sure, but have seen more than a few be wrong about determining rhythm or overcalling (or not calling) an MI.
I read the EKG. Then look at the computer read. If it has something I don't agree make sure there isn't something I'm missing.
I think you can turn the computer interp off on many of these machines. The computers are good at measuring rate andintervals, PR, QTc, etc but weak at most else.
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Had one "computer" reading two shifts ago that called a true 3rd degree heart block.... "Second-degree, Type-1".
The MLP discharged the patient. My name on the chart. I never saw the EKG until the bounceback.
Patient is fine. No damage.
You best be sure that I'm going to have a talk with the MLP. Here's the real kicker; the patient had full workup (by MLP), and I was only talked to briefly to select an antibiotic for her "URI". No mention of EKG findings.
Moral of the story? Supervise your MLPs. Hard.
The MLP discharged the patient. My name on the chart. I never saw the EKG until the bounceback.
Patient is fine. No damage.
You best be sure that I'm going to have a talk with the MLP. Here's the real kicker; the patient had full workup (by MLP), and I was only talked to briefly to select an antibiotic for her "URI". No mention of EKG findings.
Moral of the story? Supervise your MLPs. Hard.
wtf...
^^Yep, fold back, read and interpret, unfold, if computer findings differed figure out why you're right / comp is wrong or vice versa
Does your ED not require the doc to interpret every EKG? Even then something can be missed if your colleague looks at it very quickly.
There is a policy where the doc needs to look at every EKG, but this is sometimes not actually what happens - part-timers don't know this, and the locums just don't care.
Here's how this fell thru the cracks. Patient got to the ED 2 hours prior to my shift. Doc "on-duty" should have looked at it; probably didn't. After workup is done, MLP aks me to dispo patient, and "lists" the patient as being under my care. I never got to see the EKG. This MLP, in particular, is 8 months out of PA school, and doesn't know what she doesn't know. Worse than that; she doesn't want to hear that she could be wrong.
Here's how this fell thru the cracks. Patient got to the ED 2 hours prior to my shift. Doc "on-duty" should have looked at it; probably didn't. After workup is done, MLP aks me to dispo patient, and "lists" the patient as being under my care. I never got to see the EKG. This MLP, in particular, is 8 months out of PA school, and doesn't know what she doesn't know. Worse than that; she doesn't want to hear that she could be wrong.
Good for Rhythm (mostly) but much worse for ischaemia. They are pretty good at picking up a STEMI though. I think they are important because there will times you are overwhelmed with tons of stuff and when a tech shoves an EKG in your face, seeing "ACUTE MI" on the reading makes you focus on it a bit more despite your (most likely) sleep-deprived state.
...oh god
Ditto. Ours can't even relinquish it to the residents - they can look, but they can't touch until an attending has it.
