This is the disclaimer. I say a bunch of generic crap about how my opinion is worthless, nothing can be taken as medical advice or valid training, and that I only correct or screen the most heinous of errors once a year or so.. so you’re on your own.
I say that, because it’s true. Be skeptical of everything. I am a new surgical intern, and even folks with far more training than I struggle with this kind of interpretation. Just because I have the wherewithall to get this on the web and know some big words doesn’t mean I’m always right, let alone generally right.
Before publishing cases I ask experts (EP cardiologists/fellows, senior cardiology attendings, and highly EKG-savvy medicine and critical care attendings) for an expert review of the discussions and final impressions of these strips, but that is far from a guarantee of validity.
The nature of the medium is that they too will miss things, or have only skimmed my overly-wordy analyses for the gravest of errors, and many strips are open to interpretation anyways. Sometimes one extremely senior reviewer will see a strip and have a very different interpretation than another extremely senior reviewer. Heck, I often disagree with myself or see new and significant findings when I review cases a second time. Any misinformation propogated here is my own fault and not that of my reviewers, probably due to my own amateur misunderstanding of their review. However, any misinformation picked up here and then applied to your patients resulting in harm is your own fault, for using an amateur’s internet blog instead of an electrophysiology fellowship plus a critical care fellowship.
You should be especially wary of the management implications suggested, as these are the points I have the least experience with, and are the most situationally dependent.
Anyways, don’t give up hope. There’s great stuff here and you can learn a lot. Maybe I can tickle your brain a little, and if I’m lucky: get some feedback and improve my own skills. I’ll provide one way to analyze the strip, and maybe we can crowd-source the best interpretation..
Don’t take this to the bedside without adequate training and/or supervision. Every rhythm interpretation and management decision is only valid in the precise clinical settings that you will only know in the moment. I am not responsible for anything you do. You are. And this is serious business.
On that note, if you see any errors, I am very interested in hearing about them. Feel free to comment so that everyone may benefit from the discussion, or email me personally.
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