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Help with static cardiology

Posted · Report post

OK. Looking for help, preferably from someone with Education or a psych backround.

Here is my story. Graduated from paramedic school, did alright. I took my national practical test, and passed 11 out of 12 stations "flawlessly" (per the DOH rep). The last station of the day was static cardiology. It was late, I was pretty tired, but confident.

I went into the room, and knew the proctor. My mind went out of control. Every rhythm and every protocol was running through my brain at the same time. I could identify the strip, but what I thought and what I said were two different things.

I failed. Now, I should have filed a grievance, as the cards were quite old, ink was faded, and the lamination very cloudy. I did not find out later that many did not pass that station, and there was an issue with the same cards at the last test.

Against my better judgement, I retested the same day, other strips from the same old, faded set. I failed.

On Thursday, I retested static, and my mind became a blur again. This time, a different location with different cards. I failed.

Obviously, I have an issue with the static cardiology station. I am not a brain, but obviously stayed awake long enough in class to pass dynamic, as well as ACLS and PALS.

Can anyone offer any assistance in surmounting my "phobia"?

Does NREMT offer an alternative testing style?

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Posted · Report post

While this might not help you in and of itself, it is useful information to know. While stress increases memory of a specific event ("flashbulb" memory effect), it also decreases memory recall during the stressful event. Is cards your weak subject, and hence more stressful then the others? Did you feel more stressful going into it since it was the last test of a long day?

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Posted · Report post

The static portion is there for a reason. Like in real life, one may have to make hasty decisions of an ECG in a hurry, even from poor readings of monitor such as poor printing, artifact, electrical interference, etc.

Stating you passed AHA ACLS and PALS is not credit as well, We all know the credibility of such is not worthy and really hardly no-one fails those courses anymore.

What I do suggest is to make flash card style of ECG's, even those with poor tracing. Better if you can convince someone else to do it., so you will not be "memorizing" strips. There are plenty of strips on the Internet, one can paste and copy.

Get plenty and only allow small amount of time for interpretation, using the usual and proper measure of interpretation. Usually < 30 seconds. Study hard and practice.

Good luck,

R/ r911

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Posted · Report post

My suggestion is make sure you READ the scenario. Don't skim over it quickly, don't stare at the strip in front of you, do what you'd do on a real call with a real patient. You look at your patient as you are walking in. What's your first impression? That's what the scenario will provide you with. If you see the 80 y/o female weak, dizzy, with a SpO2 of 88%, B/p of 90/60 who is pale, cool, and diaphoretic, then you look at the strip and see a slow rhythm you can immediately discount almost half of the rhythms you know, and focus on identifying the rhythm and providing the treatment.

By reading it thoroughly you will also catch anything buried in the middle of the scenario...such as 33 y/o male found stabbed in a bar, he's warm, dry, pulseless, apneic, oh yeah...PEA :)

Lastly...take a few deep breaths...if you're hypoxic, you're patient will be too!

Good Luck and study hard

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Posted · Report post

If you have the cash, go see a psychologist that does hypnotherapy. They can anchor it so that when you go into that testing environment you will get calmer, clear mind, etc.

You can also just practice yourself. Practice relaxing the hell out of yourself (look up techniques online), then go through the test in your mind again with vivid detail, repeat a a few dozen times. It's basically classic desensitization.

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Posted · Report post

Well, my friend it seems that you have let yourself develop a "fear" of the station. My suggestion would be to just "relax", and as was previously stated, read the scenerio. This stuff, although it be difficult, is not rocket science. Although, some medics would like for you to think it is. DO NOT let yourself be stripped of "confidence". If you have read your books, and had a chance to work with some good medics, that are willing to teach, you will do fine. I am not surprised to hear, that the equipment used for your testing is old, and worn out. This unfortunately , is often the case. But that is another discussion. Remember this, you are probably up on more of the new training, laws, dosages, and skills, than the proctor evaluating you. This is because you have just taken the course. I have been the proctor for testing medics, and the worse thing I see, is that some "ParaGods" have gotten the student so intimidated, that they are too nervous to do what they are proficiently trained to do. Just relax...... :wink:

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Posted · Report post

Good advice from riskynremtp. It does indeed sound like the stress of this particular event is possibly as much a factor as your cardiological skills.

Regardless, if static cardiology is not second nature to you, you simply are not ready for the streets. Unlike pharmacology, there are no cheat sheets to get you through the sticky situations in the field. You either can read them quickly, under stress, without help, or you can't. And if you can't, then I don't want you wearing the patch. Unfortunately, paramedic licensure doesn't mean you are now ready to go learn. It means you are now ready to go practise on human lives. Alone. Without any help. You need help, so you are not ready.

That's not necessarily a bad thing though, so long as you recognise it and do something about it. If you don't already have the Dubin EKG book, go buy it today. Sit down with it for two days straight and work through it cover-to-cover. Do that again the two days before your retest. Not only will you pass the test just fine, you will actually be better at EKGs than most of the medics you work with.

But with three fails, don't you have to like do a refresher or something before you retest? I am not sure. I've never heard of anybody failing the same station three times before, so this is new territory for me.

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I completely agree with Dust...if it's not rolling off your tongue then you probably aren't ready for the streets. I just did my practical skills on Friday and passed...what i did was make note cards....on one side V-Fib on the other side i wrote my treatment and i did this for every rhythm out there. Since I was good at recognizing the rhythm but always messed up on the treatment. or you can put a rhythm strip on the front and treatment on the back...I took these note cards EVERYWHERE with me for about 3 weeks they were always in my purse. if i had 10 minutes to wait for a meeting or apt i would study them...in the line at the grocery store...

Dubin's book is fantastic i know that most Barnes and Noble stores carry them.

good luck!!

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I don't know if this help but...

I decided before I did my skills testing that I wasn't going to take any tests at all. It seems to me that the information I cram before a test lasts juuusssttt long enough to pass the test! And then much (most?) of it is gone. So I decided to view the testing as a benchmark instead. I didn't want to know if I could pass, I wanted to know what I knew.

So 4-5 days before the tests I put my books away, didn't study, didn't review, I just tried to get everything EMS out of my head, curious to see what would come out during the testing.

I got right with the fact that I was going to have to retake every station at another time, which was a small price I thought for having a decent idea of what information I owned, and which was just circulating around in the front of my brain soon to be forgotten. There was no stress, because there were no tests.

I went in, followed the logic trees (whithered though they may be) that had naturally grown over the months in my little brain, said the next thing that seemed to make sense to me...and flew through without issues.

I'm not sure if that would work for you, or anyone else, but I passed all the stations, plus left knowing that at least some of what I was insecure about being able to access when I need it had actually taken up permanent residence in my head.

Good luck to you!

Dwayne

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Posted · Report post

I see you posted this in 05 so im sure youre well done with this but for anyone else out there thats trying to take these tests the best advice i have is its all theatre. Medic school is like reading one of those choose your own ending books. If you memorize your lines and know "what to say" its all just rehersal and putting on a show. If you have good instructors though, they will take the time and explain a lot of the whys? about what to do that way if you are thrown a curve ball you can think your way through it.

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