EKG Tips for Urgent Care Patients

Jennifer Carlquist, PA-C, and course director of The Urgent Care EKG Course shares a few helpful tips when looking at EKGs from patients in urgent care.

  1. What could it mean when your patient has an inverted T wave? An inverted T wave is normal in AVR and V1. If seen in any other lead, can be a clinical conundrum when you encounter it in urgent care. The 4 differential diagnoses you should consider are: ACS, PE, Cardiomyopathy, and Intracranial hemorrhage.
  2. When determining the rhythm, it is important to ask yourself 3 questions: Is it regular or irregular? Is it fast or slow? And is the QRS wide or narrow? These 3 questions can really help you narrow it down.
  3. If a patient has chest pain in urgent care, the decision point on whether they need to go to the ER or have an outpatient work up relies on multiple factors. We should consider their age, their co-morbidities and also the description of pain. The EKG should also be scrutinized for subtle ACS findings. Knowing these findings is critical.
  4. When making a STEMI determination, you must know the criteria. This includes looking for two contiguous leads with ST elevation and leads with reciprocal changes. If you don’t have reciprocal changes question your STEMI diagnosis. (Unless the ST elevation is in V2 and V3)
  5. Right bundle branch blocks can be confusing. If new and in the setting of ACS symptoms, RBBBs can be indicative of MI. We are traditionally taught that ACS can only cause new Left Bundle branch blocks. However, this is not the case. 

This course is ideal for PAs and NPs practicing in urgent care. Whether you’re new to practice or have many years of experience, you’re sure to learn practical, evidence-based tips you can use on your next shift. You can sharpen your EKG interpretation skills, improve your accuracy, become more proficient, and boost your clinical confidence with The Urgent Care EKG Course.

Visit https://www.ebmedicine.net/ekg to learn more.

Even more content:

Check out one of our latest reels (less than one minute!) on 3 tips on how to stay safe when working in urgent care from Jennifer Carlquist, the course director.

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