53 Sinus Dysrhythmia

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(31:01) This week Ron learned about dysrhythmia – and wonders whether the interpreting of rhythms is an art or a science. Ron and Kelly discuss different methods of reading strips, whether or not Ron should have multiple sources for learning to read them, and the difference between ECG and EKG.

Mentions

Basic Arrhythmias by Gail Walraven
Rapid Interpretation of EKG’s by Dale Dubin
Taigman’s Advanced Cardiology (In Plain English) by Syd Canan, Charly D. Miller, Mike Taigman

Pocket Reference to The 12-Lead ECG in Acute Coronary Syndromes by Tim Phalen, Barbara J Aehlert
12-Lead ECG for Acute and Critical Care Providers by Bob Page
Tom Bouthillet’s EMS 12-lead blog

Assessing Mental Status article

Can they really refuse your care? by Kelly

Listener Questions

An anonymous caller asks about how to navigate being the new guy, when there are HIPAA violations and other questionable practices in the service where they are employed.
Harry Ford sends in an interesting cheat/trick when checking uniformity in a rhythm strip. Kelly comments on the idea.
Can a basic take PHTLS?
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  • Kelly, I just took PHTLS this last week & talking with the instructor, they DON’T have a separate test for EMT-B’s they take the same test as Medics & are scored on ALL the questions including the ALS ones. when I was team leader for the scenarios we had I would say that I would have one of my medic partners handle the ALS procedures(starting IV’s, doing needle crics, & chest decomps, etc) & I stuck with doing  the BLS ones.   One question though, I was thinking about taking either PALS or ACLS, since I’m a Basic would I be in way over my head if I took either one of those ?? I’m also thinking about taking AMLS would that be a good idea as well ???

  • Anonymous

    That’s a new one on me, Kenneth. I haven’t taught PHTLS in 4 years, but I was a PHTLS Instructor for 14 years, and EMT-B students were always graded only on the BLS questions on the test.

    Let me check with some of my sources.

    As far as the skills go, I’d have taken every opportunity to actually practice those skills in the learning stations, but do as you did and delegate that to your medic partners in your scenarios.

    ACLS is a bit of a stretch for an EMT-B because of the cardiology and pharmacology (although it’s far less than there used to be), but PALS is mostly about assessment and BLS interventions. Most of it is easily understood by an EMT-B. The same is true of AMLS. There is some ALS care in there, but the course really should be named Advanced Medical Assessment. It’s a challenge for an EMT-B, but it’s doable.

    If you get the chance, take a PEPP class in your area.

  • Anonymous

    Per my sources, you’re right. That’s a change from the way they used to do things, but the vast majority of the questions on the test are BLS questions. Even if you missed every ALS question, you still have an excellent chance of passing it.

    I applaud you for taking it!

  • Thanks Kelly. I did try the ALS skills in the learning stations. It was a nice preview of what I have to look forward to in Medic Class.

  • A quick comment to Kelly regarding face sheets. In my experience, the content of the face sheet is often facility dependent. In most hospitals, the face sheet is billing and, maybe, allergies. However I’ve often seen face sheets from SNFs that also includes the admitting diagnoses on the face sheet.

    For the caller, one that that I liked from my second company, which was a small 2-3 ambulance non-emergent service (IFT would be a misnomer since most of the patients were under home care) was that they kept the info sheets in a binder in the office at the station. So if we wanted to we could write down all of the information for the call before we even went on the call.