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I left medical school with a poor understanding of ECGs. I asked him how he became so comfortable reading E C Gs. Stephen mentioned he took a course with Dr. So, I started reading the cribsheets. It helped but still did not provide the foundation I needed. In the beginning I knew very little. My mental notes were limited. However, as the days went by, my knowledge began to increase and I recognized more and more characteristics in each E C G. I took an initial first pass and reviewed the E C G.
I made a mental note of characteristics such as biphasic T waves, Q waves, and flipped T waves. It is important to get through all E C Gs in this book. At 5—10 E C Gs per day and a few days off throughout your review, this will take about 1—2 months.
Start on page 1. Read it like a book and be deliberate. Take what is being described in the text and identify the characteristics in the E C G.
In addition to reading through each section and taking notes on the E C Gs, also begin to create notecards. There are two kinds of notecards. Type 1 is simply taking an important point and writing it on the front of the notecard. Nothing on the back. No flipping. For Type 2 notecards, a statement or question is written on the front and an answer or explanation is written on the back.
These are meant to be flipped. Yes, fun. Because the knowledge you are gaining is practical. During your next shift in the emergency department or rounding on floors, you are going to recognize more and more of what you are learning every day. Your confidence is going to increase.
But this course is not over yet if you want to truly be confident at E C G interpretation. The remaining area to master is rhythm interpretation. In my experience, most ECG discussions—where the E C G gets passed around from one person to another—is when a rhythm is trying to be identified. The book is also filled with excellent pearls. Approach this book in much the same way. Take what is being described in the text and identify the characteristics in the ECG.
However, at the end of each section is a useful self-test. Do them. The book also contains an assortment of useful tables and graphs to help categorize various ECG characteristics. You now have a strong foundation. So how do we get to be in the 99th percentile?
Remember all the way back to when you started. Looking at E C Gs and struggling to characterize them. However, this time you are going to have much more knowledge and understanding of what is going on in each E C G.
For some of you this may seem too easy! It is serving to solidify what you already know and fill in the gaps for your weaker areas. Forgetting ultimately leads to a better understanding. The harder you work to retrieve forgotten information, the more solidified it becomes in your long term memory.
You can stop now and you will have an understanding of E C Gs that will last your entire career. You will be able to glance at an E C G and make an accurate diagnosis.
The last habit to create is to follow up the E C Gs that you interpret while working clinically. Often, a patient is admitted for a dysrhythmia and ends up on the medical floors or intensive care unit.
Even better, some patients end up in the electrophysiology lab. Follow them up. Find out how other people interpreted their E C Gs. This habit—the follow-up—is the fastest, least expensive way to becoming an expert. Find out when you are right and learn from when you were wrong. If you are also interested in learning ECG interpretation from clinical vignettes in an online Qbank take a look at these opportunities for emergency physicians , family medicine physicians , pediatricians , pediatric emergency physicians , and PAs.
If there are no ups and downs in your life, it means you are dead. ECGs for the Emergency Physician 1. Type 1 notecard. Type 2 notecard. Arrhythmia Recognition: The Art of Interpretation. Email First Name Last Name. Categories: Study strategies.
Related Articles. Comments 1. Name Email not displayed in comments Website Comment. Daniel June 28,
Electrocardiography in Emergency, Acute, and Critical Care, 2nd Ed.
Click here to download free chapter! Right then. And quickly. Despite many believing that it is a static science, our understanding of electrophysiology continues to evolve.
ECGs for the Emergency Physician 1
ECGWEEKLY: Be the best at electrocardiography!
I left medical school with a poor understanding of ECGs. I asked him how he became so comfortable reading E C Gs. Stephen mentioned he took a course with Dr. So, I started reading the cribsheets.