I “over-diagnosed” an ECG. Maybe you should too.

It’s important to be wrong now and then. Not just for the usual blather about being humble, understanding cognitive biases, or even nailing the Kobayashi-Maru test. Don’t do it Saavik… No, it’s important to be wrong in the right sort of way, a willingness to be humble in the interest of patient care. Let me explain! Case #1: I was sooo right. EMS brought in a middle-aged male who was “found on the floor,” having been their for an unknown period of time. Their medical history and medications were also unknown, and his altered mental status didn’t help. Vital signs were okay, although the heart rate was unexpectedly low for someone who looked sick and dehydrated. While my resident was examining the patient, I talked with Sara, the paramedic, about the ECG. “Huh,” I said to Sara, “funny it’s so slow, since he looks dry as dust. T-waves also look a bit funky – I wonder about hyperkalemia. Hey, don’t be afraid to empirically treat if the history and ECG make you suspicious.” We grabbed our own ECG in the ED: ACUTE MI? Wat R U doin computer stahp This was also supportive of hyperkalemia, and so I pushed calcium before waiting for the lab results. The potassium turned out to be 6.3.  #JediECGskillz   #AmIGoodOrWhat Case #2:   #OrWhat An elderly female with no prior ECGs, or records of any sort, was brought in by EMS with a report of “altered mental status.” She actually seemed mostly okay to me, but the veteran paramedic, Chr...
Source: EMS 12-Lead - Category: Cardiology Authors: Tags: 12 lead ecg Source Type: research