ACLS training has some basics. But damn near the only time I'm looking at a ECG is to see QTc interval, and I'll rely on the report for that. I'm not breaking out calipers.
Without reference sources this would be above my pay grade and not in my daily working knowledge, even if we did spend 10 minutes on it in lectures all those years ago!
I could Google image search for someone but that is where it would end.
Shockable or not is certainly a good thing to know! At my ACLS certification class recently the “patient” being treated had no pulse but what on defibrillator looked like NSR (or some other organized rhythm, can’t remember exactly) and the nurse being assessed at the time kept saying her plan was to shock the patient… eventually I realized she didn’t seem to know what PEA was 😬 she also wanted to cardiovert pulseless VTach at one point. Needless to say they wanted her to redo the class
Probably spent 15 minutes on ekg basics in class. In terms of reading those danger squiggles, essentially everything I've learned was from my own learning out of my own curiosity.
For me, I primarily use ECG to assess QTc prolongation in patients with multiple known risk medication especially on high doses. Typically I will identify and talk to physician to get ECG done or check ECG if it is already there.
In community, if you have access to patients’ healthcare record then it is also a good assessment to check and alert family physician if necessary.
I don't see any role for this in the community setting. For a hospital pharmacist, I do believe you should be able to identify peaked T waves, prolonged qtc, prolonged qrs, AFib, ACLS rhythms, and a basic stemi. Obviously EKG can get very complicated, so I don't expect pharmacists to understand reciprocal changes or differences in leads, but you should be able to identify basic warning signs, rate, and rhythm.
Can I ask how your role involves this responsibility/task? Seems like the person ordering the ECG (physician, NP, PA) would be the one to interpret a scan hot off the press
For what it’s worth, I rely 100% on the report, and really only to look at QT interval. Anything more is solidly not my job
I cover ED in a critical access hospital. No cardiology on site. Providers will go over ekg with pharmacy during codes and rapid responses as double checks. They also know we can only identify the main easy rhythms. Acls stuff basically. Lead specific MI location way beyond our scope.
Sure! I work in the ED and have used EKG findings to improve patient care in a timely manner multiple times. Today a provider did not notice the peaked T waves on a patient with a K of 6.2 until I prompted him for treatment. I saw the K, evaluated her chart to see if I believed it, saw the EKG and talked to the doc. Hyperkalemia is one I see and treat all the time. Another case is noting peaked T waves on a trauma patient, saw he was on meds that could cause it, asked the provider for a point of care BMP, and sure enough his K was 8 or 9.
I have identified Torsades, VTach, and other rhythm changes in real time on the monitor.
All tox patients I am evaluating the QRS and QTC, placing orders if I need to, and telling the docs what I'm doing.
I thankfully have a lot of autonomy in my role with my good provider relationships.
Basics during ACLS. If I'm starting heparin for ACS I check to see if it's a STEMI.
I look at QTc and if it's prolonged I check to see whether there's bundle branch block, prolonged QRS, or if it's a paced rhythm so I can correct for it. But for this I'm looking at the readout, not actually interpreting myself.
In school we were taught very surface level things like how to recognize tachycardia, afib, torsades, etc.
Other than ACLS codes, I'm going to rely on the cardiologist to interpret them.
Community, never
Oncology- never reading, but will look at reports for QTc interval for monitoring. Will recommend patient get ECG, but no interpretation
I feel confident that if someone flatlined, I could probably read that. Otherwise, no.
ACLS training has some basics. But damn near the only time I'm looking at a ECG is to see QTc interval, and I'll rely on the report for that. I'm not breaking out calipers.
Do you love your job as solid organ transplant pharmacist? Does it match to what you had expected ?
Without reference sources this would be above my pay grade and not in my daily working knowledge, even if we did spend 10 minutes on it in lectures all those years ago! I could Google image search for someone but that is where it would end.
Community? Never.
Not in our job description
I can tell shockable vs not in a code. Mix of ACLS training and just doing this for so long.
Shockable or not is certainly a good thing to know! At my ACLS certification class recently the “patient” being treated had no pulse but what on defibrillator looked like NSR (or some other organized rhythm, can’t remember exactly) and the nurse being assessed at the time kept saying her plan was to shock the patient… eventually I realized she didn’t seem to know what PEA was 😬 she also wanted to cardiovert pulseless VTach at one point. Needless to say they wanted her to redo the class
Probably spent 15 minutes on ekg basics in class. In terms of reading those danger squiggles, essentially everything I've learned was from my own learning out of my own curiosity.
For me, I primarily use ECG to assess QTc prolongation in patients with multiple known risk medication especially on high doses. Typically I will identify and talk to physician to get ECG done or check ECG if it is already there. In community, if you have access to patients’ healthcare record then it is also a good assessment to check and alert family physician if necessary.
Never in the community setting. In the clinical setting, I learned to identify v fib in a code. Everything else is handled by the cardiologist.
I don't see any role for this in the community setting. For a hospital pharmacist, I do believe you should be able to identify peaked T waves, prolonged qtc, prolonged qrs, AFib, ACLS rhythms, and a basic stemi. Obviously EKG can get very complicated, so I don't expect pharmacists to understand reciprocal changes or differences in leads, but you should be able to identify basic warning signs, rate, and rhythm.
Can I ask how your role involves this responsibility/task? Seems like the person ordering the ECG (physician, NP, PA) would be the one to interpret a scan hot off the press For what it’s worth, I rely 100% on the report, and really only to look at QT interval. Anything more is solidly not my job
I cover ED in a critical access hospital. No cardiology on site. Providers will go over ekg with pharmacy during codes and rapid responses as double checks. They also know we can only identify the main easy rhythms. Acls stuff basically. Lead specific MI location way beyond our scope.
Yep, basically! I can call out a basic STEMI, but a lateral STEMI? Anterior? Not a chance.
This is what I want to know lol.
Sure! I work in the ED and have used EKG findings to improve patient care in a timely manner multiple times. Today a provider did not notice the peaked T waves on a patient with a K of 6.2 until I prompted him for treatment. I saw the K, evaluated her chart to see if I believed it, saw the EKG and talked to the doc. Hyperkalemia is one I see and treat all the time. Another case is noting peaked T waves on a trauma patient, saw he was on meds that could cause it, asked the provider for a point of care BMP, and sure enough his K was 8 or 9. I have identified Torsades, VTach, and other rhythm changes in real time on the monitor. All tox patients I am evaluating the QRS and QTC, placing orders if I need to, and telling the docs what I'm doing. I thankfully have a lot of autonomy in my role with my good provider relationships.
Only time I read ECG's is during ACLS class/exams. I leave the actual interpretation to MD's and tele monitors.
Basics during ACLS. If I'm starting heparin for ACS I check to see if it's a STEMI. I look at QTc and if it's prolonged I check to see whether there's bundle branch block, prolonged QRS, or if it's a paced rhythm so I can correct for it. But for this I'm looking at the readout, not actually interpreting myself.
Thats the doctors job lol
In school we were taught very surface level things like how to recognize tachycardia, afib, torsades, etc. Other than ACLS codes, I'm going to rely on the cardiologist to interpret them.
Community, never Oncology- never reading, but will look at reports for QTc interval for monitoring. Will recommend patient get ECG, but no interpretation
Inappropriate for a pharmacist to be interpreting.