TSP ECG

TSP ECG #2

Male, 76y/o

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Comment on rate, rhythm, axis and anything abnormal you can find.

Analysis

This quiz is a learning tool and is designed to promote discussion, so if you disagree with our analysis, sound off in the comments below; we’re learning, too!

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ECG Difficulties

I never considered just how difficult trace analysis could be. Don’t get me wrong; I knew it would be hard, I just didn’t fully appreciate quite how hard.

During lectures on specific arrhythmias, when ECGs are displayed, they generally contain the abnormalities that make up the subject matter so it doesn’t take long to come to the correct answer, but looking at a trace without any history or prompting as to the condition, is still overwhelming to me. So overwhelming, in fact, that I often feel like I’m falling short of the mark with regards to my learning as a whole. The TSP ECG section is as much for my benefit as it is for you guys, in that I’ve found analysing the ones selected for posting incredibly difficult.
No matter what answer I come to, there’s always the lingering worry that I’ve missed something.

How much is too much, with regards to analysing?

What’s a result of over-analyzing, and what’s accurate?

Textbook traces, whether clinical, or stylised, have been selected as the best possible example of the rhythms under scrutiny, so it stands to reason that they won’t exactly mimic those that will be encounered in the field. In my limited experience, clinical traces contain a great deal of variation and have thus far, rarely resembled anything you’d find in a book.

They have been difficult, yes, but they have also been possible. This will all become easier, with practice (I assume/hope), so I hope you all find the analysis quiz good practice, as it’s certainly proving to be that for me.

 

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Review: Analyze ECG Reporting

Download for Google Play: Free

Download for iOS: Free

Developer: Cathal Breen

Analyse phone

 

When you’re just beginning to get to grips with analysing a 12-lead, taking a methodical approach is recommended, but in practice that’s easier said than done. Remembering what you’re measuring, and in what order you’re measuring it, is sometimes confusing, especially when, like me, you’re still getting your head around the various concepts behind the plethora of arrhythmias and pathological morphologies you’re likely to find in a patient ECG.

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I’ve already covered the tutorial apps documenting normal and abnormal values that I felt were most beneficial to PTP students, but Analyze ECG Reporting by Cathal Breen exists solely to guide the practitioner through each, single analysis and serves as a methodical reminder of everything that should be documented in your report.

Analyse is nicely presented, with a very simple user interface set up for each section. The display contains boxes for measured values, buttons to advance to the next measurement, or to go back to make corrections and some pop-up menus for comments on the ECG waves. It doesn’t suffer from a text overload, or clutter in any way. The colour scheme is visually appealing, but conservative, so when using the app, you’re kept on task and not distracted by needless images or too many different colours.

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This app is merely a way to educate practitioners into using the same approach to study each trace. It may seem like an obvious thing to point out, as ECG cannot provide a diagnosis on its own, but Analyse is not an algorithm that will diagnose a pathology for you.
This is not to diminish this app’s merits whatsoever, though. Analyse does a great job of clarifying the process of ECG analysis and provides a list of the necessary things to include when reporting. Since installing it, I have used it to methodically review lots of the traces I’ve obtained, including those set in my coursework.

In fact, my only problem with Analyse ECG Reporting is in correcting mistakes from the drop down menu. A long press on the option that you have selected will remove it from the final list, but this isn’t explained at any point. It took me a little while to figure it out, so some brief instructions wouldn’t have gone amiss upon starting up the app for the first time. It’s a minor niggle and it didn’t detract from my overall experience with Analyse, however.

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Consistency and a methodological approach are key parts of analysis, and Analyse ECG Reporting is a great trainer. This app is a must have for PTP students, but I’d recommend it to any student who’ll have more than a passing dalliance with electrocardiograms.

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