12-Lead ECG for Acute and Critical Care Providers

by Page, Bob

• ISBN13: 9780130224606
• ISBN10: 013022460X
• Edition: 1st
• Format: Paperback
• Copyright: 2005-01-26
• Publisher: Pearson

Summary

Written by a paramedic with experience teaching at all levels (EMT-P, nurses, etc.)--and based on the objectives of the new DOT curriculum--this user-friendly volume presents a practical, easy-to-understand system for 12 lead ECG interpretation and assessment. A focus on the "need to know" information and a large number of practice cases--withactual12 leads--provides readers with the solid background and extensivehands-onpractice that will help them gain confidence and build competence quickly. Includes sturdy reference cards (detachable from the book) that users can use for reference in actual clinical situations.Lead Placement and Machine Logic. Finding your way around a 9, 12, or 15 Lead ECG. The 12 Lead Assessment. Rapid Axis and Hemiblock Determination. Bundle Branch Blocks. Who's at Risk for Complete Heart Block? Ventricular Tachycardia: Primary Assessment. Acute MI Recognition. A System for Assessing for MI: The Secondary Assessment. Acute MI Clinical Implications. Chamber Enlargement. Electrolyte Changes. Miscellaneous Conditions. The Benefits of Monitoring Lead MCL-1. Difficult Diagnosis: AMI in the Setting of LBBB. Practice Cases.For EMS Education/Paramedic Programs, Critical Care/UMBC programs, and Nursing/Critical Care of Emergency Care programs.

Author Biography

Bob Page is an internationally known speaker, instructor, author, and paramedic

Table of Contents

Lead Placement and Acquisition of the 12-Lead Electrocardiogram

Understanding the 12-Lead ECG Printout

Determining Axis and Hemiblock

Understanding Bundle Branch Blocks

Determining Patient Risk for Complete Heart Block

Wide Complex Tachycardia

Acute Myocardial Infarction Pathophysiology

ECG Patterns of Infarction

Locating the AMI: The Secondary Survey

The 15-Lead ECG

Left Bundle Branch Block and Acute MI

Chamber Enlargement

Electrolyte, Drug, and Other ECG Changes

Putting It All Together

Answer Key

Table of Contents provided by Publisher. All Rights Reserved.

Excerpts

It doesn't have to be difficult. I have always believed in the ability of people. When I began my career in acute medicine, "upper-level" knowledge always had a mystique. Medicine is cluttered with paradigms on how things should always be done. I can recall boundaries to learning. Skills were assigned to the level of licensure. For example, a paramedic could do this, a registered nurse could do that, and only the doctor could perform certain procedures and tasks. Reading the 12-lead ECG was one of those things reserved for the doctor.I recall sitting in on a few classes with physicians and some experienced cardiac care nurses to learn this advanced knowledge. Armed with an aboveaverage skill at recognizing basic cardiac rhythms, I set out to learn. It was after the first slide that I learned that I was in way over my head. Sure, I could recognize a P wave, but I could not spell or pronounce some of the information. One thing I did remember, however, was ST segment elevation. I saw a picture of that on the first slide. For the next 7 hours and 55 minutes, I did not understand why all the technical measuring and laborious tasks required for recognizing this elevation were necessary.I remember an occasion when my paramedic instructor pointed out ST segment elevation on a Lead II rhythm strip. It really didn't faze me because, on the basis of the patient's history and complaint and the current assessment findings, I was convinced that it was a heart attack, even without the ECG. The ECG monitor was there to help me look for ectopic beats and arrhythmias.After the class, I started to ask questions and pose analogies to the emergency physicians and cardiologists who had presented the seminars. I have spent many hours in seminars and in reading almost every book I can find on the subject of 12-lead ECGs and have found that it really doesn't have to be difficult. It's all in how you learn it.One analogy I use in my seminars is that of the German chocolate cake. My sister Janie made a wonderful German chocolate cake. She made it from scratch, gathering all the ingredients and even grating the coconut and pecans for the icing. It took a long time, but it was a great cake. Now, people can buy German chocolate cake mix in a store and just add water and spread the frosting. The two cakes taste the same, look the same--they are the same. As with the German chocolate cake, I realize that there are many different ways to read a 12-lead ECG. This book presents the "just-add-water" type.Life is about change. Human beings are not programmed to stay the same. This book is based on the Multi-Lead Medics 12-Lead ECG Interpretation Workshops I have presented to thousands of paramedics, nurses, respiratory therapists, doctors, and other acute-care providers.This book recognizes the roots and pathophysiology of more complex methods of electrocardiography. Many books are available on 12-lead ECG interpretation. However, this book is greatly simplified for the acute-care provider. It is simplified without compromising accuracy. All examples and 12-lead ECGs used in this book have been over-read by cardiologists for accuracy. Compared with more traditional methods of interpretation, these methods have demonstrated comparable accuracy and increased speed of diagnosis.For simplicity, only the rapid methods of recognition are presented. Therefore, this book is comprehensive in topics, yet it is focused on a few easy-to-use methods for practical acute-care use. The book provides plenty of examples for you to practice your skills. I believe in the ability of the acute-care provider. This book is for you. Happy learning, and remember, it doesn't have to be difficult.