EKG review!!

[nope80]

Okay, I'm in serious need of EKG review before intern year starts. I never felt like a total expert in them to begin with but now that I have time, I would really like to go back and become more competent and quicker with my readings. Any suggestions on sources? Are there any books or in particular online courses/modules that are helpful?

Thanks in advanced

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[Bostonredsox]

I spent about 2 months reading and studying Thalers EKG book and then doing practice 12 leads from various sources. I highly recommend Thaler. Dubins is also good.

 

[jdh71]

nb4: cocaine and pedophilia

 

[jdh71]

the MOST important question you will want to ask as an intern when called to look at an EKG on call is . . . "Where are the old EKGs?"

Compare the new EKG to older EKG. Compare EACH segment. No changes from previous are reassuring.

Obviously you your most important feature(s) are any changes in ST segments, especially those elevations. However, like an x-ray, get in the habit of looking at it the same way every time . . . rate, rhythm, axis, PR interval, QRS duration, QRS morphology, ST segments, T waves, QTc (I like the machine tell me this).

If you don't know . . . ask.

 

[KRichards62]

However, like an x-ray, get in the habit of looking at it the same way every time . . . rate, rhythm, axis, PR interval, QRS duration, QRS morphology, ST segments, T waves, QTc (I like the machine tell me this).

Agreed. I've seen people get burned not doing this. For example, a patient developed new onset chest pain and the resident focused all their attention on the ST segments, completely missing that the patient was in complete heart block. Seems impossible to do, but when a nurse is shoving an EKG in your face at 3 AM you would be surprised what can be missed if you do not go through the all the check points.

 

[ForeignBody]

What has already been said is certainly true. Would just add that as an intern, the most common thing you will probably see is Afib with RVR. Get good at reading the EKG and knowing the management. There are a lot of iterations, new onset (no history of afib) what else do you need to check and do, new onset (in somebody with hx of paroxysmal afib), etc.. Pt has marginal BP with AFib RVR, do you shock now or is there some other explanation for the guys hypotension. Like he is septic with AFib RVR and a marginal BP. It just goes on and on.

 

[indiamacbean]

this is what you're looking for:
http://www.amazon.com/12-Lead-Ecg-Interpretation-Tomas-Garcia/dp/0763712841

the next step beyond garcia and holtz:
http://www.amazon.com/Complete-Guid...=sr_1_1?ie=UTF8&s=books&qid=1304007251&sr=1-1

then for more practice:
http://ecg.bidmc.harvard.edu/maven/mavenmain.asp

 

[indiamacbean]

dubin. not a great book imho. not a great guy either:

Dale Dubin Sentenced To Five Years
Proprietary to the United Press International 1987
March 7, 1987

A federal judge sentenced millionaire plastic surgeon Dale B. Dubin to five years in prison for what the judge called an obsession with pornography and cocaine that turned the doctor's life into a tragedy.
U.S. District Judge William J. Castagna told Dubin at a sentencing hearing Friday he could not see how a ''person of your talent, ability, education and interest in art,'' could have turned his life into such a ''tragedy and waste of such a rare and needed talent.''
Dubin pleaded guilty six weeks ago to 22 counts of child pornography and cocaine charges.
Eleven of the drug counts involved a 16-year-old girl who was seduced by Dubin with the help of pills and vodka and eventually agreed to participate in sexual encounters with Dubin, another 17-year-old girl and a 23-year-old woman.
Dubin videotaped some of the encounters for his pleasure. The incidents took place at two of his condominiums and the Pasco County nudist resort of Paradise Lake.
He is expected to serve his time in a minimum security facility where he will be able to receive drug counseling.
U.S. Attorney Robert W. Merkle, who prosecuted the case, told Castagna that no crimes ''are more violent than the use of child pornography and the distribution of narcotics.'' He said Dubin's attempt to minimize his activities as just a ''lifestyle'' was a ''new low in euphemisms.''
Merkle said it was particularly aggravating that Dubin used his medical knowledge to satisfy his own appetite and risk the lives and mental health of his victims.
Dubin, 47, stood with his head bowed throughout the 40-minute hearing Friday. Except for a few mumbled words about a letter to the judge, he did not say anything.
In that letter, Dubin complained of the ''lurid display'' of his case by prosecutors and claimed details of his activities were ''egregiously distorted'' by the press. He also spoke of his sexual escapades as examples of ''an occasional clandestine soiree.''
Dubin was arrested Aug. 11 at the mansion in Lutz, Fla. he called Hassle Free, after being sucked into a child pornography sting by sending off a $100 bill to buy films including ''Barbarian Girls.''
The Dubin story received extensive news coverage as his doctors unsuccessfully tried to have him committed to a mental hospital for treatment of what they called potentially suicidal depression, and Merkle countered by adding details of the case into the court record.

 

[haitham]

Take it from one who bought a lot of EKG books to master EKG.....Clinical Electrocardiography is the best one......written by Aryl Goldberger.....you will be astonished by the simple yet thorough way the book is written!

 

[Loanna]

I'll second Clinical Electrocardiography by Goldberger. Very nicely written!!!!