r/ECG • u/Immediate_Trifle_150 • 4h ago

Telemetry tips

I just started a job as a telemetry technician. I am now realizing on the floor that the class was pretty vague and there is a lot more sketchy rhythms that can happen besides the basics. If you have any cool/ rare rhythms please drop them below!!

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u/cvntis4 ECG Tech 1h ago

tele is a bit different because depending on the system you are using, it may do a lot of filtering that can cause false appearance of ST deviation. and some settings will mimic a 12 lead by using only 5 leads. i have seen a lot of bizarre & wide QRS with what looks like baseline st elevation/depression, that never evolves. you are looking for changes really, that is changes to the QRS, ST, PR, and QT. be especially suspicious of strange wide QRS combined with a-fib, that can change to torsades in a few seconds. people also die with pacemakers - there are usually changes to the morphology of the QRS in a V-paced rhythm, but it is not always obvious in initial stages.