# BLS EKG Interpretation



## emtbls (May 26, 2013)

Does an emt-b have any business knowing major heart dysrhythmias?  I could see how it would help, but is there ever a time someone would ask you to analyze or give an opinion over the radio?


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## DesertMedic66 (May 26, 2013)

It would help broaden the EMTs knowledge but no it's not really needed. 

For my scope I can place a 12-lead and get a recording that I can transmit to the hospital but I can't read the strip (per protocols). 

If for some reason you have to tell the hospital what a EKG strip says you would either be reading the machines interp of it or be repeating what your medic tells you.


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## sir.shocksalot (May 26, 2013)

I think EMTs have every business knowing arrhythmias. If you are working an ALS truck being able to look at the monitor and evaluate the rhythm will help you anticipate your medic's needs. If someone is in V-Tach/Fib, as an example, you won't have to wait for prompting from your medic to place pads. Or if you see a run of SVT/V-Tach or other kinds of ugliness that your medic didn't see you can at least give him/her a heads up of what you saw.
If you are working in the ER you might be the only one looking at the monitor when weird stuff happens. It's simply good knowledge to have if you plan on working in any capacity as an EMT.

Needed though? No. Although many things you should be doing aren't necessarily in the 'need' pile.


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## TomB (May 26, 2013)

As a paramedic do I have any business knowing how to read a chest x-ray? The question itself smacks of arrogance, turf protection, and an attitude that learning isn't for everyone. It's not part of the EMT scope of practice to read electrocardiograms. But it's everyone's duty to be a life-long student, IMHO. If you're curious about ECGs, gap junctions, nuclear fission, or supernovae, have at it my friend! It's nobody's business to tell you that learning isn't your business.


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## VFlutter (May 26, 2013)

TomB said:


> As a paramedic do I have any business knowing how to read a chest x-ray? The question itself smacks of arrogance, turf protection, and an attitude that learning isn't for everyone. It's not part of the EMT scope of practice to read electrocardiograms. But it's everyone's duty to be a life-long student, IMHO. If you're curious about ECGs, gap junctions, nuclear fission, or supernovae, have at it my friend! It's nobody's business to tell you that learning isn't your business.



I agree however it sounds like the OP is asking about using that knowledge in clinical practice as in interpreting a rhythm and calling report which is still outside the scope of an EMT. Personally, I am pretty good at reading chest x-rays but that does not mean I am going to call the doctor and give him my interpretation without waiting for Radiologist''s report.


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## Aidey (May 26, 2013)

Around here if crap his the fan sometimes the EMT with call the hospital from the front. In those cases they are expected to give a full report, including EKG. I don't have a problem at all with an EMT calling report with "ALS" information that their paramedic told them to relay. The only time I could see an issue is if the EMT is both interpreting it and calling report, without any corroboration of their interpretation.


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## VFlutter (May 26, 2013)

Aidey said:


> The only time I could see an issue is if the EMT is both interpreting it and calling report, without any corroboration of their interpretation.



That is what I meant with my post. An EMT interpreting and calling a report independently.


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## troymclure (May 26, 2013)

TomB said:


> As a paramedic do I have any business knowing how to read a chest x-ray? The question itself smacks of arrogance, turf protection, and an attitude that learning isn't for everyone. It's not part of the EMT scope of practice to read electrocardiograms. But it's everyone's duty to be a life-long student, IMHO. If you're curious about ECGs, gap junctions, nuclear fission, or supernovae, have at it my friend! It's nobody's business to tell you that learning isn't your business.



^ this!


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## NomadicMedic (May 26, 2013)

I've purchased two copies of Dubin's book to give as gifts to BLS people who showed a genuine interest in learning more about rhythm interpretation. 

It's not "paramedic exclusive knowledge".


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## Aidey (May 26, 2013)

Chase said:


> That is what I meant with my post. An EMT interpreting and calling a report independently.



I just wanted to clarify, because an EMT calling report while their medic partner is swamped does happen. I didn't want someone reading this thread and thinking they can't say "ALS" stuff on the radio if their partner tells them to patch.


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## KellyBracket (May 26, 2013)

TomB said:


> As a paramedic do I have any business knowing how to read a chest x-ray? The question itself smacks of arrogance, turf protection, and an attitude that learning isn't for everyone. It's not part of the EMT scope of practice to read electrocardiograms. But it's everyone's duty to be a life-long student, IMHO. If you're curious about ECGs, gap junctions, nuclear fission, or supernovae, have at it my friend! It's nobody's business to tell you that learning isn't your business.



So true.

Another perspective: In my ED, techs (most of them EMT-Bs) record ECGs and deliver them to me & the other physicians. A few of them know enough about ECGs to know what a quality tracing looks like, obtain a small amount of history, and recognize potentially concerning findings on the ECG. They have pride in their job, and a level of competence beyond what is strictly required, and it is a pleasure to work a shift with them.


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## Christopher (May 31, 2013)

EMTom said:


> Does an emt-b have any business knowing major heart dysrhythmias?  I could see how it would help, but is there ever a time someone would ask you to analyze or give an opinion over the radio?



It is a matter of who you work with. Do I think you should learn how to interpret an ECG? Why not. If you ride with me I'd make sure you learned how.

Should an EMT give that over a radio? Unless you are running an ALS patient in because you don't have an ALS unit available, probably not.

If you're with me in the back of the truck and doing my call in for me, have at it hoss.


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## medic741 (Jun 1, 2013)

It's really helpful to the medic if you can, so if attention is diverted from the monitor and ya see something funky you can say what is other than uh that was weird. 

If that happens don't forget to hit the PRINT BUTTON!!!


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## chaz90 (Jun 1, 2013)

I don't know how much interpretation skill you need if it's to the point of "looking funky" on the monitor screen. Any EMT worth anything knows to make sure the medic sees if it's suddenly really fast, really slow, or really different.


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## emtbls (Jun 7, 2013)

medic741 said:


> It's really helpful to the medic if you can, so if attention is diverted from the monitor and ya see something funky you can say what is other than uh that was weird.
> 
> If that happens don't forget to hit the PRINT BUTTON!!!



I think this comment has a lot of merit.  If it's wasn't obvious, I was looking for an excuse to learn the common arrhythmia.  However, when a new EMT-B like myself is trying to get dialed in to BLS work it can be little more than a distraction. :wacko:


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## CritterNurse (Jun 8, 2013)

If an EMT has the curiosity to learn to interpret an EKG, I say more power to them. Sure they can't diagnose a rhythm at that license level, but they can turn to the paramedic, pretend they're on Jeopardy and answer in the form of a question.



> Hey, does that look like a-fib to you?



Assuming of course they have a paramedic with them who is open to EMTs asking questions like that.

I've picked up a couple rhythms over time, but I can say with complete confidence "That don't look right" when it isn't NSR.


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## NomadicMedic (Jun 8, 2013)

If you're going to do it, learn the methodology of rhythm interpretation, don't just try to memorize strips. 

Grab Dubin's book, learn WHY sinus rhythm is normal, learn why a P wave comes before the QRS complex... learn how to determine each rhythm by rate, wave interval, morphology and regularity and then build from there. It's a little like learning a new language. Soon, you'll be fluent.


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## lanceavil (Jul 10, 2013)

During my clinicals the ED tech and one of the nurses showed me how to hook up a 12-lead and showed me some of the more basic arrhythmias, that was pretty cool. It's good to know what v-tach/v-fib looks like, for example.


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