Week 6: 12-Leads in High Tech Lab

This week I was back again in high tech lab for my third and final time of the semester. Having another high tech experience without being distracted by fancy skills such as IVs and drug administration, meant that I was able to focus on improving the basics, which are far more important in my future career. Yesterday provided an excellent opportunity to dust off the scenario "boots" after Reading Week.

Delegation in Scenarios

One of the areas of feedback that our Lab Tech gave me on scenarios was that I can (and should) delegate more tasks to my partner - such as physical tasks as well as cognitive tasks to my partner. For example, my first scenario was a drowning VSA and our Lab Tech recommended that I delegate to my partner timing 2 minute intervals so that I can remove that cognitive load from myself. I often find delegating difficult in real life as well as in scenarios because I don't know which tasks are best to delegate and I often find explaining things takes more time than to complete the task myself. To improve, I have written down the multiple components of scenarios and what tasks I think would be good to delegate. I also need to confirm with our Lab Professors what tasks we are allowed to delegate; are we allowed to delegate a head-to-toe assessment? If we delegate OPA insertion, do we verbally explain the procedure? There is also the challenge of making sure that delegated tasks are completed correctly. If you delegate a head-to-toe assessment, did your partner auscultate the lungs and check for JVD? To me, having to do this confirmation seems to take more time than completing the task myself. Despite this, I know that I will be a far better medic if I can learn to effectively share the workload with my partner.

12-Lead Interpretation

Yesterday, I also had the opportunity to practice 12-lead interpretation. Our Lab Tech was an excellent instructor and provided a lot of support with understanding how and WHY to interpret 12-leads. I am somewhat embarrassed to report that I learned yesterday that 12-leads only look at the left ventricle and we are primarily using a 12-lead to identify if the patient has a STEMI. Our Lab Teach explained looking at the J-point and how we use that to measure the ST segment while comparing to the TP segment for a reference point. Our Lab Tech also gave us insight into what to look at first, the inferior wall (aVF, II, and III) as a STEMI there rules out nitroglycerine administration. After initially feeling discouraged about how little I knew, I looked at my patho notes last night on "Introduction to 12 lead ECG's". Reviewing this material, reinforced the teaching from our Lab Tech. My previous knowledge was pretty much - chest pain, ask for a 12-lead, but not really knowing why or how to interpret the print out. Thankfully, yesterday changed this for the positive!