One morning in August 2007 I sat down for my very first one day St. John’s Ambulance first aid course. The course can be boiled down to “put your hands firmly on anything that was recently not oozy and red”, CPR and remember to call 911. As the TV set, surely borrowed from a museum, played what could have been the poorest 45 minutes of acting ever to grace VHS I sat mesmerized. I looked like Homer’s mom in the episode where she becomes a beatnik rebel. Staring wide-eyed at the TV while Jefferson Airplane played and my mind expanded. I was hooked. I had to know… everything. What makes a person’s heart stop? Yeah but, why? What does ventricle fib-erlation mean? And thus began the addiction. Along my never-ending journey to understand cardiovascular emergencies I have spent a considerable amount of red bull and time driving significant others crazy learning about EKG interpretation. Below are a few useful resources I have accrued along the way.
- Rob Theriault’s Cardiac Dysrhythmia Interpretation (CDI). Rob has over 20 years experience in the Canadian prehospital care environment and is currently a program coordinator/instructor of the PCP/ACP (BLS/ALS) program at Georgian college. Located in the free, and awesome, iTunes U Rob has 40 brief (3-5 min) video lectures followed by 40 practice strips. The material begins with coronary anatomy, EKG basics and then discusses various arrhythmia’s. Click here, then within iTunes click Paramedic Programs, then scroll to the right and click ECG Dysrythmias. If you do not have iTunes then download it. It is free, you have no excuse.
- the ECGpedia. Wiki-type site with numerous brief articles. Easier to digest than the more indepth EKG resources.
- Dr. Callan’s Cardiac Arrythmias. What this video lacks in title creativity it more than makes up for in sheer awesomeness. I came across it one night at 3 am while I, as any normal person, was up trying to understand bundle branch blocks. BBBs were amongst three rhythms I had been trying to understand for two months which Dr. Callan clarified in 4 minutes.
- Dr. Delago’s March, 2010 lecture at the Albany Med EMS lecture series. The lecture is just over half an hour long and Gus does a great job explaining why certain leads are representative of ischaemia, injury and infarct in different areas of the heart. To watch the video version of the lectures you require Real Player (free) which I reccomend. If you cannot download Real Player the Albany Med podcast series are available on iTunes.
- To test your comprehension ply your craft on this EKG rhythm simulator.
- As you begin to move from rhythm interpretation towards 12-lead interpretation I highly suggest these 16-20 min video lectures. Never before, under any circumstances, did I foresee considering an Engineer as a resource for clarification. Jakko Malmivuo does a great job at exactly that. The lectures are recorded at a University in Finland and Jakko does an excellent job explaining the theory behind EKGs.
- Blaufuss Multimedia produces EKG simulation software for training purposes. They also, thankfully, produce a free version. Click the orange start banner beside ECGviewer and you are presented with very high-resolution 12-leads (note you must have Shockwave’s multimedia player installed). Also included on the site are a very neat look at auscultating various murmurs and cardiac pathologies.
- Prehospital 12-lead ECG. This blog is produced by Tom Bouthillet, a Lieutenant with Hilton Head’s Fire Department. Tom is also a Critical Care EMT-P instructor, an avid member of the EMS online community, and very vocal on improving D2B time and other STEMI programs.
- Dr. Venkatesan’s cardiology blog. Although much of the material on this blog is written for, well, cardiologists I recommend it for RSS feed inclusion. Dr. Venkatesan writes in an easy to follow and brief manner discussing very unique and original topics. For example how drinking a normal sized bottle of water suppresses recurrent Syncope more effectively than a pacemaker.
- QxMD’s ECG app for smart phones. I am not very big on smart phone apps (my electrical-taped BB and I are not on the best of terms) but I feel this one is worth honourable mention. For $9 CAD you get a very in depth explanation of advanced 12-lead ECG interpretation and over 120 high resolution, zoomable, tracings.