Time flies

Another year in the books, hopefully we've learned a great deal about EKG's with some of the pitfalls or surprises they can present. With the close of one year comes the opening of another. There're big changes coming up for many of us. For some of you it will be your first true professional job. …

I didn’t actually

lose my car keys that is. And I'd say to google it for those of you who missed my lecture a couple weeks ago, but you really don't want to. (and it didn't come up when I tried a minute ago so you're safe either way!). As opposed to our patient, he may be less …

How good is your fence?

Or AV node as it turns out. Some lumber I've used to make a little windbreak for lakewatching at the beach ... note the foot of sand that's blown in around the base and you might get a hint of where the EKG is going this week Let's jump to the EKG and see just …

kind of a trick

Sometimes life isn't logical. Little bits of irony or surprises can throw a person off. Sometimes those surprises are pleasant, like a flower in the snow... Skunk Cabbage "flowers" actually perform some sort of exothermic chemical reaction that allows them to melt their way out of the ground Other times we can get thrown off …

Sometime’s it’s exotic

We all know what we're supposed to do when we hear hoofbeats. Look for a horse, right? Not a zebra? Or when we hear screeching. In that case the most likely answer for most of us is a psyche patient heading off the rails, and not a pair of blue-and-gold macaws. Except every now and …

a red herring?

or red Alaskan salmon as the case may be? moving on to the EKG... Rate sits just over 100.  Rhythm appears to be sinus.  Axis is left.  The QRS should draw the eye somewhat.  In some leads it looks narrow, in others it looks wide.  In some it looks ... narrow and wide.  Let's zoom …

What’s half a wolf?

A coyote of course. But does that logic apply to EKG's? Rate looks to be pretty normal, likely around 80.  Rhythm is a little trickier.  Many of you were concerned for 3' AVB, but I don't see any lost P waves.  There is something going on with the P waves (which we're going to come …

who wants to mow my grass

I've managed to swell an arm to nearly double size the last 2 times I've cut mine since there's a yellow jacket nest I can't find and apparently local reactions to stings increase as you get older.  It's also a good year for massasauga rattlesnakes; they're in the peak of their 3 year population cycle.  …

Subtlety

Or maybe it wasn't so subtle, who knows.  I came across a book that some of you may be familiar with, The Subtle Art of Not Giving a F*ck.  It probably applies more to wellness than it does to EKG interpretation, but one of the relevent principles in the book is that problems are inevitable; …

Zebras in the ED

There's a lot of little tidbits of knowledge that you learn in EM that may (or hopefully) may not manifest themselves in your practice; exceptions to the mass casualty rules for lightning victims, what to do WHEN JELLYFISH ATTACK, etc etc.  But every now and then one of those will walk into your ED.  (But …