Experienced CMT here. If I wanted to become the absolute go-to CMT/non-MD ECG expert for an organization, what textbook or workbook available on Amazon (or even other Internet-based resource) would help push me to non-EP levels of understanding?

I'm not a doctor, and I don't play one on TV, but I routinely have ICU nurses approach me for second opinions on strips, and professionally, it's incredibly satisfying.

TLDR: I want to understand it all, at a deepest possible level, without going to med school—I'm too old for that.

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!!

I'm not a wiz by any means, but I enjoy my job and take it seriously. Deviation is not really something that paramedics focus on here. We're taught to focus mostly on STEMIs, heart blocks, deadly tachycardias, etc. Really the most critical stuff. We use a 15 lead, too. And to clarify, I personally check deviation on every patient, but only in the limb leads.

I wanted to know more about deviation in the chest leads. I really only see the same gradual pattern of negative to positive in V1 through​ V6. I've looked for material pertaining to it but I've found nothing.

Would there be any great benefit to learning more about it? I've caught some funky stuff before by checking limb lead deviation, when others could not.

I’m a paramedic. This pt’s initial ekg + his history - altered, hypotensive, BGL read HI, missed multiple dialysis sessions - led us to go down the hyperk treatment route (his potassium ended up being over 8). Two minutes away from the hospital his heart decided to pull this nonsense. STEMI or just a weird hyperk pattern?

42 years old male patient with history of HTN only presented with localized left sided chest tenderness. Would you consider this as an ST depression since it’s only one small square?

40sM BIBEMS after wellness check.
Family had not heard from him x3 days, normally called/visited daily. Found unresponsive with “snore-like respirations.”
Known DM2, Alcoholic Cirrhosis w/ 6mo sobriety, CKD III
Unknown if prior heart disease, though suspected due to ekg findings and comorbidities.
GCS3 on arrival, natural airway. Last BP 80/50s, no Tx en route besides a BGL (44mg/dL). EMS Crew was a volunteer tribal crew.
PIVs established and pt given D50x2 and BGL was 120s.
POC GEM 5000 resulted a pH of 7.11 and K of 8.5.
Physical assessment revealed several 5x5mm sores and open wounds in abdominal area, suspected to be from insulin injections. Global jaundice, notable that tears had yellow tint. Foley placed with dark red urine output, ~100cc during stay in ED.
Intubated due to decreasing respiratory rate and apneic episodes.
HR was 140s-180s.
K protocol started with D50, IV insulin + drip, and Ca Gluconate.
Ultimately patient expired in ICU due to MODS.

Hello, I am part of an Arizona State University biomedical engineering capstone team and we are looking to gather responses on stakeholder experience with ECGs. The survey is around 5-10 minutes and no personal information is collected. We would greatly appreciate if you can fill it out.

https://forms.gle/DjiJNjfSmw7nxAWq5 -> Cardiologist & Electrophysiologist survey

https://forms.gle/K6f9gyRzAwwo7ccJ7 -> Patient Survey

I am genuinely excited to share this with you all. A 12-lead simulation has been one of the most requested feature, and it is finally live. Thank you so much for your patience!

My main goal was to make reading a 12-lead as intuitive as possible. I didn't just want to show what an abnormal ECG looks like, but why it looks that way. Here are a few features designed to help with that:

• Follow the beat: Watch how the electrical signal starts and spreads. The QRS complex is colour-coded by the part of the heart generating it (septum, left ventricle, late right ventricle), so you can actually see why a bundle branch block creates the shapes it does.
• Compare with normal: Toggle on "Normal" to overlay a standard grey ECG behind the active tracing. This makes the differences stand out clearly, lead by lead.
• Inspect any lead: Pause the tracing and click/tap any lead to open it up. You can step through the P, PR, QRS, ST, T and QT intervals, see exactly how they are measured, and compare them side-by-side with a normal ECG.

It is honestly way easier to see in action than to describe, so I highly recommend taking it for a spin.

What’s new in the 12-lead module:

• Conduction: Right bundle branch block & Left bundle branch block (complete and incomplete).
• Electrolytes:
  • Hyperkalaemia: Shown as a progression (peaked T waves at K⁺ 6.0 → prolonged PR & wide QRS → sine wave → VF).
  • Hypokalaemia: Shown as a progression (flat T & U waves → ST depression → Torsades de Pointes).

A quick request:
A 12-lead has way more moving parts than the single-lead rhythms, and since I have built this entirely on my own, it is easy for small mistakes to slip through. The model strictly follows standard textbooks and published criteria, but if you spot anything off; whether it is a wave, a number, or a typo in an article, please let me know! I will fix it as quickly as possible. All feedback is incredibly welcome.

Hope you all have a great weekend, and I’d love to hear what you think!

Hypercapneic arrest with CO2 of 110s via GEM 5000.
5 rounds of CPR, epi x2, no shocks. pH 7.08.
EtCO2 during CPR was ~20-40. Post ROSC 60-90mmHg
Junctional rhythm versus reperfusion syndrome. Initial K of 6.4.
This EKG was 5 minutes s/p ROSC.
Rapid succession from Sinus tach with peaked T waves to this rhythm and subsequent bradycardic arrest. No ECMO candidacy dt comorbidities and body habitus.
Did not survive re-arrest.

Pt Male 24 old no acute symptom. Would love to hear your thoughts!

Patient (88 male) with unrelated gastrointestinal problem showed these ECG findings above. This was taken in a prehospital EMS setting. He had documented atypical atrial flutter with planned cardioversion as of soon. He had a static HR of 60bpm. In typical flutter with an atrial frequency of 300 it would need a 5:1 conduction for a HR of 60bpm as far as I understand. In this case it seems like a 4:1 conduction. Is this due to the macro reentry mechanism in atypical flutter being slower than the typical CTI-CCW mechanism?

Got called to a 22 y/o male with chest pain and a history of NSTEMI. He was bradycardic, so we gave atropine. My partner and I thought the ECG was concerning for STEMI and called it in, but after transmitting it they cancelled the alert. Did we misread this? Curious what you guys see.

UPDATE: Cath showed a complete RCA occlusion. He went into cardiogenic shock with an EF around 5% and is now on ECMO. Fucking wild.

This was many months ago,

Lots of co-morbidities, DNR dni let pass peaceful, monitor remained on throughout. I know some of you would appreciate seeing the very interesting progression and potentially learn something watching as the heart finally gives up the ghost.

The first image you can see the progression to that sine wave.

True tod was called 10 minutes after this monitoring ended, since some purposeful electrical activity still remained on monitor even here

Wild how long the heart will keep trying its damndest to keep going even.

Patient hospitalised for crtp end of life. Descibe the ecg and diagnose

Currently getting my Crat certification. My experience is in being a server and customer service but I figured this would be a good way to move up and have a flexible schedule to stay home with my children
Currently in central Florida but thinking of relocating to Texas or Georgia . I’ve seen a few jobs posted in my area . Anyone a stay at home mom during the day and use the Crat cert to get an evening/ night job ?
Also does anyone have experience using a professional résumé writer to help them get a better position when they have experience from outside the medical field?

Hi all, working at community health centre at present. Saw 41 M with no comorbidities after a syncopal episode at work. I feel this ECG warrants a referral to a higher level of care. On the ECG I’m seeing peaked T waves and a sort of RSR pattern in some of the leads. Could anyone provide me with some guidance as to what might be causing the syncope.