I Feel Stupid

[crotchitymedic1986]

Its a problem now because this is probably the first time she has been tested since she took her Paramedic Registry Exam. I know there are departments out there who really do training well, and ensure that their medics are competent, but the reality is that probably 95% of EMS agencies rely on CPR, ACLS, and a quickie weekend 40 hour refresher course two weeks before their certification expires.

[HERBIE1]

Listen right now, I need to focus on getting through my 12 Lead test. We did do 12 Leads with one of my services, but I don't think I did them that often with the second service I worked with. This could be the reason why I am extremely rusty.

Try a different method of learning- maybe your style of learning has changed over the years. Maybe you used to be a visual learner, but now you need to adapt your study habits. Try a different source for learning- a new book, a new web site, etc. Flash cards, rhythm strips- whatever you need.

Go back to the basics and start from square one, as if you had never seen this information before. Maybe you made some assumptions/short cuts/ pneumonics/tricks over the years that have skewed your interpretation of cardiology and EKG's.

As you noted, if you don't use it, you lose it. That's why so many of us are rusty when it comes to pediatric cases. Even in a high volume system, things like a pediatric medical arrest are rare. A couple months ago I had a patient who was allegedly around 3-4 months pregnant and had a prolapsed cord. It was a shock because the call came in as a woman in labor, and just prior to our arrival on the scene, we were told the "baby" was out. Imagine my surprise when our "baby" was actually about 3 inches of the umbilical cord. It took a moment to readjust- and I had to instruct the first responders on the scene in the proper treatment. I was rapidly going through the protocol in my head- it had been awhile since I had dealt with this. After the call, I went back and reviewed my OB/GYN emergencies just to brush up.

[Richard B the EMT]

Don't feel stupid. I'm an EMT-B for almost 38 years, and in refresher classes, I still have brain-freeze on "Patient Evaluations", probably because I have to slow down to break down all the components, instead of just doing them.

Think of it this way: A centipede was asked with which of it's thousand legs it started walking with, and the critter never moved again, trying to recall the information.

[HERBIE1]

A centipede was asked with which of it's thousand legs it started walking with, and the critter never moved again, trying to recall the information.

LMAO

I like that one, Richard.

Seems similar to the "paralysis by analysis" issue that lawmakers or management types often have a problem with.

[+medic]

PM sent with N.H. info.

[ctmedic09]

Kim,

If you are still seeking help I would first suggest to you Dale Dubins book. It is the simplest read on cardiology that breaks everything down to an understandable level. The next step is just start going through sample EKGs and case studies. The most important thing I teach my students about 12 leads is to est a method of interpreting them. I start with lead II and assess for rate and rhythm. Next I start at Lead I and work my way down strictly analyzing the ST segment and T-Wave changes. After I have identified if I have ST changes I group them in contiguous groups i.e II,III,avF. I want to apologize if I simplify this too much I am not meaning to question intelligence, From that point I determine if I have two or more anatomically contiguous leads with ST elevation and determine if I have a STEMI on my hands. That process is about 20 seconds at looking at the EKG. I hope this helps if you have anymore questions or are in need of some sample EKGs I would be more than happy to forward some along.

Chris