Recognize Lethal ECG Rhythms: Conquer the Patient Clues – Robin Gilbert

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Register today to advance your ECG skills! Leave with brand new insights to recognize not only lethal rhythms, but other diagnoses that can present with ECG changes. Learn how to assess for other patient clues that will help you analyze the complete clinical picture and initiate crucial interventions.

Imagine taking care of your patient when he suddenly becomes pale, diaphoretic, and tells you his heart is “going crazy”. You check his pulse…because that’s what nurses do… his heart rate is rapid and his blood pressure is 70/50. You connect him to the cardiac monitor get a stat ECG. His rate is >200, it looks like atrial fibrillation, but the QRS is wide…OH NO!! 

Reading ECG’s proficiently takes practice and fine tuning over time. Experienced nurses from various departments and units have admitted to feeling terrified of ECG’s. Yes….terrified to miss something that the patient’s ECG is indicating. You don’t need to know everything, but you do need to know how NOT to miss the big stuff! 

1. Determine how pathological events can explain abnormalities on a 12 lead ECG.
2. Practice an advanced step by step process to interpret ECG abnormalities.
3. Evaluate the intricate placement of chest leads and limb leads.
4. Apply criteria to distinguish heart blocks.
5. Devise a treatment plan based on the type of arrhythmia.
6. Analyze actual rhythm strips and 12 lead ECG’s.

Cardiovascular: A & P Basics

• Cardiac conduction system
• Conduction system and waveforms

Tips and Strategies

• 12-Lead vs. 15-Lead – and why
• Explaining limb leads and precordial leads
• Contiguous leads
• 5 step process for interpreting ECG’s
• Assessment tips

Axis Deviation

• Why, how, and significance
• Quick approach for determining axis

Blocks

• 1st, 2nd, 3rd Degree 
• Bundle branch blocks in a nutshell
• Causes and complications

STEMI, NON-STEMI, Unstable Angina

• Initial presentation
• ECG’s changes
• Interventions

How Common Are These?

• Brugada syndrome
• Wolf-Parkinson-White
• Long QT syndrome

Confidence in ACLS Emergencies

• Treatment for wide vs. narrow complex tachycardias
• Cardiac pacing
• Asystole/PEA
• VT/VF

What Critical Concern is Behind the Disguise?

• Pericarditis
• Myocarditis
• Heart Failure
• Tako Subo
• COPD
• Electrolytes
• Pulmonary Embolism
• Ventricular Hypertrophy
• Subdural Hemorrhage
• Aortic Aneurysm

Upcoming Attractions

• Assist devices
• ECPR
• REBOA

Let’s Wrap It Up

• ECG and Rhythm Strip Practice
• Case presentations