Adventures in Learning ECG Interpretation

MMiz

I put the M in EMTLife
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I purchased and read Dale Dubin's book a couple of times. I understand very little of it, it's as if I am reading a foreign language.

I'm now looking for:
  1. Rate - Understand
  2. Rhythm - Is this just rote memorization?
  3. Axis - Still not sure about this one. Can't even formulate questions at this point.
  4. Hypertrophy - Okay
  5. Infarction - Got it
Now what? Do I just keep reading the book over and over again until it makes sense? Should I be memorizing EKG strips? Is all hope lost.

This doesn't bode well for an advanced career in EMS. Help!
 

StCEMT

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2: Kinda, but understanding how everything works will make that side of things easier to remember.

3: What I wrote above applies here.

Understand how everything is supposed to work normally. Then apply that to what each rhythm is doing and why. If you understand why things are doing what they're doing, you aren't just memorizing random names and numbers, but understanding the concept. Knowing the various measurements is important, but it's easy for things to overlap and you have to think beyond a set of numbers you memorized. Ex: not every wide complex tachycardia can be labeled VTach
 
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MMiz

MMiz

I put the M in EMTLife
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@E tank Maybe they have an Apple watch with the ECG interpreted for me? I like your thinking!

@StCEMT Really appreciate your response, and it makes sense, thanks.

In the short period since posting this question I found using flash cards helpful in learning/identifying rhythms.
 

Tigger

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Trying to memorize rhythms is pretty difficult. For me it came down to first understanding the electrical pathways in the heart. Then I looked at how each distinct piece and interval of the QRS related to those pathways. Once you have these down, it's much easier to understand what you are looking at. In the beginning I made a large chart with all the rhythms on the X and every interval and characteristic I could think of on the Y. So things like the p wave presence and type, QRS duration, PRI, regularity, rate, etc. I'll have to see if I can dig it out. But once I knew all of these it was much easier to look at a rhythm, identify that it was not sinus, identify what was missing/abnormal, and then figure it out from there.
 

Gurby

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Dubin is the worst. So bad. The WORST!

In paramedic school, I read through Dubin cover to cover and still had absolutely no clue about anything. And I’m really good at book learning. This is to say that you shouldn’t feel bad. The problem is the book, not you. Probably.

Check out Tom Garcia’s book if you really want to learn EKG’s. In 4 years of undergrad, 2 years of paramedic school and now 2 years of medical school, it’s almost certainly my favorite educational book and the only one I still own a paper copy of. Can’t recommend enough.

It’s expensive, but there is a pirated ebook you can find pretty easily online. That said, a big part of what makes the book great is that it has ~300 full size 12 leads for you to practice interpreting, so owning the full size hard copy is well worth it. I used to bring this with me every shift on the ambulance to review.
https://www.amazon.com/12-Lead-ECG-Interpretation-Garcia-Introduction/dp/0763773514/
 

Tigger

Dodges Pucks
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I found The Only EKG Book You'll Ever Need pretty helpful as my first foray as well. Never read the Dubin book.
 

StCEMT

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I'll second Garcia's. I've read a couple books and skimmed others and it is the best by far that I have read. It's my cardiology Bible.
 

akflightmedic

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#2 This is where A&P of the heart comes into play.

If you understand this, then glancing at ECGs is a breeze.

But yes, you can do rote memorization and not truly understand why you are seeing what you are seeing, just knowing if you see x then it possibly means Y and I should give Z. This is how I started...then I went back and rebuilt my house with a solid foundation.
 

VFlutter

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I really liked Dr. Mattu's books for practicing 12 lead interpretation.
https://www.amazon.com/ECGs-Emergen...TF8&qid=1546485100&sr=1-1&keywords=amal+mattu

Keep working on the basics and focus on the most common life-threatening arrhythmias and injury paterns. The more complex and subtle stuff will come with time and practice. Ya it is nice to be able to differentiate AVNRT vs AVRT but in practicality it doesn't really matter.

Just like Ventricular Flutter is a real rhythm....
 
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