Thursday, April 22, 2010

Right-sided MI's

So, I was responding to a post by RevMedic over at EMS Haiku (go there to see the actual strip) who was talking about a right-sided MI he might have caught through careful assessment and so on. I was talking about a tip that I got from a doc during a clinical on the medic unit, and realized Hey! This is one of those things I could put in my blog!

So here it is. Thinking logically, the lead V1 in a 12-lead EKG is the exact reciprocal of the lead placed on the back in a 15 of 18 lead (I don't know which one, since we haven't studied them, only talked about them briefly). Therefore, if you see a depression in V1, you should expect that there is reciprocal elevation in that lead on the back. Thinking further, the lead on the back is pretty much directly over the right ventricle, and therefore it makes sense to see elevation there.

So yeah. While it is not diagnostic by any means, seeing ST depression in V1 lead, when you don't see reciprocal elevation in any of the reciprocal leads, should lead you to suspect a right-sided MI, and move your leads over to double check.

Sunday, April 18, 2010

A small light

I'm beginning to get excited. Only 2 more clinical shifts left for this semester. It's been fun, but I'm heartily tired of waking up at 0500 or earlier every damned morning, including weekends.

This weekends clinicals were relatively boring. A pseudo-busy shift at the hospital (you know the ones, where you are running around all day, but at the end of the day you look at your paperwork and say 'Wow, I hardly did anything today!') and 2 days at the same medic unit (a total of 24 hours) with only 3 calls. Luckily, I don't have to worry quite so much about patient contacts this semester, but it would be nice to get at least a little ahead of the game.

On the plus side, I cranked out the last 4 trauma homework assignments, finished my take-home test, and did almost all of my clinical paperwork yesterday and today. The only school work left is 2 papers, various tests (of course), a presentation, and the NREMT-I test. There are some other issues that I have to work out, which is it's own ranty post, so stay-tuned.

Paper due Thursday, paper due Monday, then a bit of a breather till May 12th. There is a small light at the end of the tunnel, for this semester at least.