I don't remember the exact age of my son when started to focus more on reading. Ever since he was born I have tried to read to him, and as he became more of a little person and less of an animal (around 3-4 months?) the reading became more regular I think.
We are fortunate that we live within walking distance of a library, even though the hours aren't always convenient. I've made it a habit of having 5-10 books from the library at our house to supplement the usual books that he has had. I think that spending an hour a day of reading (not all at once) is the cornerstone of teaching to read. I pick out books about things I know he likes (any book about space, the moon). Sometimes he picks out books randomly but most of the time while we are there he is more interested in the blocks and puzzles they have.
I think teaching him the alphabet just happened by reading a lot of alphabet books and quizzing him on what the letters were. Around a year and a half I found that he liked it when I would open a word processor, crank up the font size to 80 or so and then let him press the buttons to make the letters appear on the screen. I could also sneak in a little learning by asking to press specific letters. Learning the sounds of the letters sort of just piggy backed on this with me asking him what sound each letter makes (either as we read an abc book or played the word processing game). I haven't really used any online programs or computer programs.
This week I got around to trying out the "Flesch Cards" (ie flash cards based on Larry Sanger's essay on reading, where he makes a pun out of a method endorsed by the author of Why Johnny Can't Read). My son hated it immediately, I was able to get through maybe 3-4 cards. Perhaps if I had introduced it earlier he would tolerate it more but I think it is just so much different than our current style of how we interact that it isn't going to work for us. Let's give it a couple more tries and see, otherwise I think I'll just stick to lots of reading with him and encouraging him to sound out the words.
Tuesday, December 29, 2015
Wednesday, December 9, 2015
Introduction to Case Reports
If you've never experienced a case report in person this will give you an overview of how they work.
A case report is a meeting, usually with a small to medium sized group that discusses a particular patient. These patient's are usually chosen because they either have an unusual disease, have an unusual presentation of a common disease, present a therapeutic challenge, or an ethical dilemma. The presentation is divided into several parts (based on how information about a patient is usually temporally collected and organized) to allow group discussion and further questioning. The following describes my experience during my residency which is probably similar to other places.
To begin with, the presenter will give a brief one-three sentence introduction to the patient, something like "This is a 51 year old gentleman who is coming into the hospital with two days of abdominal pain" or "This is a 30 year old woman transferred to our hospital after seven days of worsening rash". This will usually be followed by an overview of general questions you would ask every patient such as how long it has been going on for, where the symptom is located, etc... Sometimes, in the interest of developing the participants' history taking skills, all of the history and review of systems (ROS) will need to be teased out through questioning. For this to be particularly effective the presenter should also be asking the participants why they are asking certain questions, which will allow others to understand the reasoning behind certain lines of inquiry and how it can alter your differential diagnosis.
After the above back and forth to flesh out the HPI, the presenter will ask for initial differential diagnosis and why each one should be included. So now we have an embryonic differential floating out there and the fun will be in seeing how more information will change/narrow our thoughts.
Next, the presenter will fill in all (unless there is some obvious juicy tidbit vital to the case) of the past medical history, meds, family history. The social history should be fleshed out by the participants, as it is often a very useful source of information in complicated patients. Sometimes there will be another pause to go back to the differential diagnosis or it will wait until after the next section.
After this will come the physical exam, and usually all the basic exam is given away. If there are certain crucial exam findings that are beyond basic (basic usually defined as vital signs, general appearance, heart and lung sounds, abdomen, basic neuro exam, any obvious skin findings) these are withheld unless asked for by a participant. Again, a jump back to the differential will occur at this point.
Finally, basic labwork will be given (CBC w diff, BMP, LFTs) and participants can ask for more labwork (if available) as well as the imaging studies, biopsy results, etc... that may or may not have been done (and of course the presenter should be asking "why" to every request so that others can understand why certain things are done).
It should be mentioned that at any point people can go back and ask a question pertaining to a previous part (for example, you might want to ask about travel history after seeing the eosinophils on the CBC).
Finally, we get together for one last discussion of the differential and the diagnosis is revealed. There is usually some prepared learning from the presenter on the true diagnosis to cap it off (usually brief). Sometimes, lingering questions that would best be served with a literature search are collected and an email is sent out with the results.
That is the basic overview. The key to a good case presentation is participation and mutual respect. Nobody should be felt like they are being pimped or ridiculed for asking a question since the point of this is to bring everybody up to a higher level. Case reports are great because they teach the method of diagnosing and deductive reasoning (something not easily conveyed in books) as well as information on particular disease. If nobody feels comfortable asking a question that might make them look ignorant than everybody suffers.
In Summary:
Brief Intro --> HPI/ROS (fleshed out by questions) --> Initial differential diagnosis --> Past medical history, family history, meds, etc... (Social Hx fleshed out) --> Differential revisited --> physical exam --> differential revisited--> labs/images/ecgs/pathology (fleshed out by questions) --> differential revisited --> Diagnosis revealed --> Discussion
A case report is a meeting, usually with a small to medium sized group that discusses a particular patient. These patient's are usually chosen because they either have an unusual disease, have an unusual presentation of a common disease, present a therapeutic challenge, or an ethical dilemma. The presentation is divided into several parts (based on how information about a patient is usually temporally collected and organized) to allow group discussion and further questioning. The following describes my experience during my residency which is probably similar to other places.
To begin with, the presenter will give a brief one-three sentence introduction to the patient, something like "This is a 51 year old gentleman who is coming into the hospital with two days of abdominal pain" or "This is a 30 year old woman transferred to our hospital after seven days of worsening rash". This will usually be followed by an overview of general questions you would ask every patient such as how long it has been going on for, where the symptom is located, etc... Sometimes, in the interest of developing the participants' history taking skills, all of the history and review of systems (ROS) will need to be teased out through questioning. For this to be particularly effective the presenter should also be asking the participants why they are asking certain questions, which will allow others to understand the reasoning behind certain lines of inquiry and how it can alter your differential diagnosis.
After the above back and forth to flesh out the HPI, the presenter will ask for initial differential diagnosis and why each one should be included. So now we have an embryonic differential floating out there and the fun will be in seeing how more information will change/narrow our thoughts.
Next, the presenter will fill in all (unless there is some obvious juicy tidbit vital to the case) of the past medical history, meds, family history. The social history should be fleshed out by the participants, as it is often a very useful source of information in complicated patients. Sometimes there will be another pause to go back to the differential diagnosis or it will wait until after the next section.
After this will come the physical exam, and usually all the basic exam is given away. If there are certain crucial exam findings that are beyond basic (basic usually defined as vital signs, general appearance, heart and lung sounds, abdomen, basic neuro exam, any obvious skin findings) these are withheld unless asked for by a participant. Again, a jump back to the differential will occur at this point.
Finally, basic labwork will be given (CBC w diff, BMP, LFTs) and participants can ask for more labwork (if available) as well as the imaging studies, biopsy results, etc... that may or may not have been done (and of course the presenter should be asking "why" to every request so that others can understand why certain things are done).
It should be mentioned that at any point people can go back and ask a question pertaining to a previous part (for example, you might want to ask about travel history after seeing the eosinophils on the CBC).
Finally, we get together for one last discussion of the differential and the diagnosis is revealed. There is usually some prepared learning from the presenter on the true diagnosis to cap it off (usually brief). Sometimes, lingering questions that would best be served with a literature search are collected and an email is sent out with the results.
That is the basic overview. The key to a good case presentation is participation and mutual respect. Nobody should be felt like they are being pimped or ridiculed for asking a question since the point of this is to bring everybody up to a higher level. Case reports are great because they teach the method of diagnosing and deductive reasoning (something not easily conveyed in books) as well as information on particular disease. If nobody feels comfortable asking a question that might make them look ignorant than everybody suffers.
In Summary:
Brief Intro --> HPI/ROS (fleshed out by questions) --> Initial differential diagnosis --> Past medical history, family history, meds, etc... (Social Hx fleshed out) --> Differential revisited --> physical exam --> differential revisited--> labs/images/ecgs/pathology (fleshed out by questions) --> differential revisited --> Diagnosis revealed --> Discussion
On Teaching Reading
Because of the shift work of my job, I get to spend a lot of time as a stay at home dad. One of my goals has been to see how young I can teach my son to read. To achieve this, I have done a bit of researching on how to teach children to read, and it's interesting how difficult it is to find good information that has been vetted by experts without pernicious influence. If you just try to search "teach my child to read" you will have to wade through scores of companies trying to sell you something.
I did find the Department of Educations evidence based report, called the National Reading Panel which was request by Congress in 1997 to guide how one should go about teaching a child how to read (full report is 448 pages, which can be found here or there is am more reasonable summary here). There are probably other state and local level resources as well (and perhaps teacher union or groups) which I am not aware of. It's actually pretty sad how hard it is to find an entity that's acting (presumably) in the interest education rather than a commercial enterprise to make money. There were a lot of broken links on the government's websites. I haven't read the entire report, so although I am aware of the general overview, I'm not sure if there are a lot of details in how to teach reading in the most effective manner.
Personally, I just try to read to my son multiple times a day. Learning the alphabet was actually pretty easy (at one point we stopped because he couldn't say the three syllable letter "w", although he knew all the capitol letters, and most of the lower case ones). Next came teaching him the basic sounds of each letter, which wasn't that much harder (we haven't tried "sh", "th", etc... yet). Now I am at the point where I am trying to have him sound out words, but it is hard because he "memorizes" (often incorrectly), his books and just wants to say what he thinks the picture says rather than what the words actually say. I will post some of my own methods of teaching him in case it might help others.
I did find the Department of Educations evidence based report, called the National Reading Panel which was request by Congress in 1997 to guide how one should go about teaching a child how to read (full report is 448 pages, which can be found here or there is am more reasonable summary here). There are probably other state and local level resources as well (and perhaps teacher union or groups) which I am not aware of. It's actually pretty sad how hard it is to find an entity that's acting (presumably) in the interest education rather than a commercial enterprise to make money. There were a lot of broken links on the government's websites. I haven't read the entire report, so although I am aware of the general overview, I'm not sure if there are a lot of details in how to teach reading in the most effective manner.
Personally, I just try to read to my son multiple times a day. Learning the alphabet was actually pretty easy (at one point we stopped because he couldn't say the three syllable letter "w", although he knew all the capitol letters, and most of the lower case ones). Next came teaching him the basic sounds of each letter, which wasn't that much harder (we haven't tried "sh", "th", etc... yet). Now I am at the point where I am trying to have him sound out words, but it is hard because he "memorizes" (often incorrectly), his books and just wants to say what he thinks the picture says rather than what the words actually say. I will post some of my own methods of teaching him in case it might help others.
Friday, December 4, 2015
Online Participative Case Presentations
During my current time off, I have been working on a system to participate in case presentations online. Case presentations are a common way of sharing medical knowledge and are especially good for teaching the skill of making a differential diagnosis based on history taking and to lesser extant exam skills. They are also great in teaching how to efficiently rule in or out important differentials.
Currently, case reports are usually done in live situations at individual institutions. This can include "Grand Rounds", "Morbidity and Mortality" (AKA M&M), and "Morning Reports". More distributive methods include the NEJM's classic case report series and several other journals. To my knowledge there is no standard open source case report repository or system and that is what I'd like to work on.
In my experience, embryonic attempts at open case reports have been done with some success on reddit.com/r/medicine. However, several limitations exist. These include a need for outside links to show graphical information (such as radiology, ECGs), the lack of an efficient or elegant way for the presenter to update the entire group, and to a lesser extant the lack of real-time interaction.
I've been stewing on several ideas about how to best implement something. Creating my own website that would have all of the features i want (including a reddit-like meritocracy point system) was one plan, but it would require me to invest a lot of time into network programming. I have been looking to see if there are already platforms that might be co-opted for this and I think I may have found an answer with twitch.tv
Twitch.tv is a website that my brother introduced me to that was designed for people who enjoy watching other people play video games. I'm thinking that I could stream my desktop with a word processor for the case presentation (and images) and use the chatroom interface for the discussion. The downsides are the high bandwidth required which would limit participation from those who are practising in areas where high speed internet isn't available.
The other downside is the need for more buy in from participants (ie they need to be available for a specific time rather than with reddit they can post and leave). This is probably going to be the biggest hurdle and I think I will start by posting more case reports on r/medicine and see if I can drum up a group of like-minded practitioners who might be more willing to try this.
Currently, case reports are usually done in live situations at individual institutions. This can include "Grand Rounds", "Morbidity and Mortality" (AKA M&M), and "Morning Reports". More distributive methods include the NEJM's classic case report series and several other journals. To my knowledge there is no standard open source case report repository or system and that is what I'd like to work on.
In my experience, embryonic attempts at open case reports have been done with some success on reddit.com/r/medicine. However, several limitations exist. These include a need for outside links to show graphical information (such as radiology, ECGs), the lack of an efficient or elegant way for the presenter to update the entire group, and to a lesser extant the lack of real-time interaction.
I've been stewing on several ideas about how to best implement something. Creating my own website that would have all of the features i want (including a reddit-like meritocracy point system) was one plan, but it would require me to invest a lot of time into network programming. I have been looking to see if there are already platforms that might be co-opted for this and I think I may have found an answer with twitch.tv
Twitch.tv is a website that my brother introduced me to that was designed for people who enjoy watching other people play video games. I'm thinking that I could stream my desktop with a word processor for the case presentation (and images) and use the chatroom interface for the discussion. The downsides are the high bandwidth required which would limit participation from those who are practising in areas where high speed internet isn't available.
The other downside is the need for more buy in from participants (ie they need to be available for a specific time rather than with reddit they can post and leave). This is probably going to be the biggest hurdle and I think I will start by posting more case reports on r/medicine and see if I can drum up a group of like-minded practitioners who might be more willing to try this.
Thursday, November 19, 2015
Where are the Internal Medicine Blogs Hiding?
I've been reading medical blogs for a couple of years and it's been interesting how all the online medical education initiative seems to be carried by Emergency Medicine doctors. One can see in my own links of blogs that most of them are EM physicians. I've tried to look for blogs by hospitalists or nocturnists but google shunts me to industry publications (Like "The Hospitalist"). Where are the independent IM blogs and why isn't Internal Medicine more prominent in the #FOAMED trend?
The reason for the eminence of EM in the online FOAMED movement is multifactorial and I don't know enough about the history of the various blogs (Like Life in the Fastlane, EM Lit Review, etc...) to make an informed comment. An argument can be made that the stereotype of the ED doc's mind having limited concentration and large volumes of distractions fits conveniently into the scope of the internet. Another stereotype is that they are more extroverted and would thus be more likely to post things for everyone to see. Therefore, one could say that their specialty is uniquely suited for this sort of dissemination of information. This is just pop-psychology and probably garbage.
The reason for the eminence of EM in the online FOAMED movement is multifactorial and I don't know enough about the history of the various blogs (Like Life in the Fastlane, EM Lit Review, etc...) to make an informed comment. An argument can be made that the stereotype of the ED doc's mind having limited concentration and large volumes of distractions fits conveniently into the scope of the internet. Another stereotype is that they are more extroverted and would thus be more likely to post things for everyone to see. Therefore, one could say that their specialty is uniquely suited for this sort of dissemination of information. This is just pop-psychology and probably garbage.
Monday, November 16, 2015
Bobcat Mountain
This is a multiplication flashcard game that I made for my youngest sister a couple years ago. There's a lot of inside jokes/humor in this that probably won't make sense to anyone but it's probably the most complete "game" I've ever made.
The link is to a .rar file which will need to be unzipped with something like WinRar or some other packaging program. After it is unzipped double click on bobcatmath.exe and it should work (Windows only).
https://www.dropbox.com/s/bu8ctcutj10t9p0/BobcatMath.rar?dl=0
The link is to a .rar file which will need to be unzipped with something like WinRar or some other packaging program. After it is unzipped double click on bobcatmath.exe and it should work (Windows only).
https://www.dropbox.com/s/bu8ctcutj10t9p0/BobcatMath.rar?dl=0
Saturday, October 31, 2015
New look
I finally figured out how to get the html to a blank state so I could start from scratch with how the web site looks. Thanks to Subin at https://subinsb.com/make-a-blank-blogger-template.
I have been more focused recently on just trying to absorb a bunch of medicine and making my way through a stack of JAMAs. So much to learn. Maybe I'll start listing what I am focusing on here. Other ideas have been to keep a list of upcoming interesting studies that are being done to resolve specific questions (I haven't been able to find a good resource elsewhere other than the very very broad general databases the government runs). Someone had asked if there was a centralized area to look up CME conferences. I don't think there is and so that might be a somewhat useful thing to try to make (although not very interesting).
No recent big programming projects. I was working on a scraper but the time : benefit ratio didn't seem to be worth it at this time, though I did get to learn how to use some python scraping modules. I stopped after I had scraped the links to Annals of Internal Medicine and was in the process of adding JAMA, NEJM, but the problem is that there is still too much further sorting to be done on what is important or relevant to me.
I have been more focused recently on just trying to absorb a bunch of medicine and making my way through a stack of JAMAs. So much to learn. Maybe I'll start listing what I am focusing on here. Other ideas have been to keep a list of upcoming interesting studies that are being done to resolve specific questions (I haven't been able to find a good resource elsewhere other than the very very broad general databases the government runs). Someone had asked if there was a centralized area to look up CME conferences. I don't think there is and so that might be a somewhat useful thing to try to make (although not very interesting).
No recent big programming projects. I was working on a scraper but the time : benefit ratio didn't seem to be worth it at this time, though I did get to learn how to use some python scraping modules. I stopped after I had scraped the links to Annals of Internal Medicine and was in the process of adding JAMA, NEJM, but the problem is that there is still too much further sorting to be done on what is important or relevant to me.
Saturday, September 12, 2015
Updated Healthcare Maintenance Tool
I updated the Healthcare Maintenance tool: I added the latest ACIP HPV vaccination recommendations (which now include all men up to age 21 and further age 26 if they are MSM or immunocompromised). You'll also notice a more prominent link at the top since I feel like that is probably the most useful thing on this website.
In other news my text adventure is slowly taking shape. One hangup is how historically accurate I want to be with the theme I'm going for (which unfortunately is not well known). I also took a couple day detour trying to get the game to work with pygame but ultimately decided that it was better to be browser only.
In other news my text adventure is slowly taking shape. One hangup is how historically accurate I want to be with the theme I'm going for (which unfortunately is not well known). I also took a couple day detour trying to get the game to work with pygame but ultimately decided that it was better to be browser only.
Friday, August 14, 2015
Text Adventure Demo
I created a small demo "game" in the text adventure style. Right now it's not really that interesting but you can add/edit rooms by changing the rooms3.txt file (things are in a nested dictionary format, then the program uses that information to create objects with those characteristics). There's NPCs (although you can't fight them yet), a store where you can buy and sell things, and a couple puzzles.
I have three plans for this. Immediately, I am going to be making a small adventure (loosely based on a biography I just read on Alexander the Great). In the future I hope to use it to make some games for my son as he learns to read and type. Also, I thought it might be nice to team up with some of my more creative friends to try and collaborate on something, but we'll see if I can rope anyone in.
For the current demo you will need python, version 2 NOT 3 to run this. I didn't make it into an .exe file because it's not really a finished project and I think only people who are interested in programming will Make sure the rooms3.txt file is in the same folder as epic3.py when you run epic3.py. Here it is:
https://www.dropbox.com/sh/ylr93cccp3ccjuk/AAAvV1pn5QpmY2SUtf6RXX-Za?dl=0
In other news, I found my ECG files from residency that have a lot of interesting cases so I will scan those in sometime and update the ECG Viewer program. Maybe I'll make some nicer graphics for it.
Finally, I started thinking about a "Stay at Home Dad Helper" website that would be pretty easy to make but have suggestions of what to do if you are running out of ideas to entertain your wee ones.
I have three plans for this. Immediately, I am going to be making a small adventure (loosely based on a biography I just read on Alexander the Great). In the future I hope to use it to make some games for my son as he learns to read and type. Also, I thought it might be nice to team up with some of my more creative friends to try and collaborate on something, but we'll see if I can rope anyone in.
For the current demo you will need python, version 2 NOT 3 to run this. I didn't make it into an .exe file because it's not really a finished project and I think only people who are interested in programming will Make sure the rooms3.txt file is in the same folder as epic3.py when you run epic3.py. Here it is:
https://www.dropbox.com/sh/ylr93cccp3ccjuk/AAAvV1pn5QpmY2SUtf6RXX-Za?dl=0
In other news, I found my ECG files from residency that have a lot of interesting cases so I will scan those in sometime and update the ECG Viewer program. Maybe I'll make some nicer graphics for it.
Finally, I started thinking about a "Stay at Home Dad Helper" website that would be pretty easy to make but have suggestions of what to do if you are running out of ideas to entertain your wee ones.
Thursday, April 23, 2015
ECG Viewer Program
I finally got my ECG viewer to work as a windows application! You can download it here:
https://www.dropbox.com/s/i79vy1vcxiyo1h5/ECG_Viewer.zip?dl=0
Unzip the file and double click on the program "ECG_ViewerOnlyWindows.exe"
When you open it you will need to load an ECG. There are several ECG files in the folder "ECGs" to load and play around with.
If you download and use it for other images online, I've found that ECG images that are jpegs should be at least 500 kB in size to really be worth looking at (otherwise there is not enough detail and they are just blurry when you zoom in).
Features:
-Horizontal and Vertical Calipers
-Guidelines for calculating rate, axis, STEMI, ischemic regions, LVH, etc...
Bear in mind I have kept the graphics simple because it's a work in progress.
I also have a version of this I'm working that has a quiz mode and my goal is to allow the user to make quizzes (so that you can educate your medical students/junior residents with those ECGs you've saved).
I'm pretty sure it won't work on Mac OS, but it's worth trying (and let me know).
Any comments, suggestions, critiques are much appreciated!
https://www.dropbox.com/s/i79vy1vcxiyo1h5/ECG_Viewer.zip?dl=0
Unzip the file and double click on the program "ECG_ViewerOnlyWindows.exe"
When you open it you will need to load an ECG. There are several ECG files in the folder "ECGs" to load and play around with.
If you download and use it for other images online, I've found that ECG images that are jpegs should be at least 500 kB in size to really be worth looking at (otherwise there is not enough detail and they are just blurry when you zoom in).
Features:
-Horizontal and Vertical Calipers
-Guidelines for calculating rate, axis, STEMI, ischemic regions, LVH, etc...
Bear in mind I have kept the graphics simple because it's a work in progress.
I also have a version of this I'm working that has a quiz mode and my goal is to allow the user to make quizzes (so that you can educate your medical students/junior residents with those ECGs you've saved).
I'm pretty sure it won't work on Mac OS, but it's worth trying (and let me know).
Any comments, suggestions, critiques are much appreciated!
Saturday, April 18, 2015
ECG Program coming soon
I am currently working on an ECG viewing project. The goal was to make a program where one would load an ECG, scrool/zoom in, use calipers to measure things and have buttons that could give useful info on how to measure things like rate, axis, LVH, ischemic regions, etc... It would also have a challenge mode where you had to identify things correctly (like ECG Maven).
Currently I have broken it into two projects, one is complete and is the basic viewer where you can load an ECG and use the calipers and click buttons to help interpret it but has no "Quiz mode". I am trying to get it into an executable that will be more easily installed rather than having to have people install python and pygame to run it. For some reason I haven't yet gotten it to work, although I have done this in the past with another game I made (a multiplication game for my sister which I might put up here someday too).
The "Quiz Mode" version needs some work, because ideally I would like to make it so that the user can design their own quizzes. Currently I just have it set up with basic proof of concept quiz that I made.
I will be done with a week of nights this Monday and will have some days to tinker so hopefully I'll have the "Basic ECG Viewer" program available in a couple of days.
PS: Originally I had planned on incorporating detailed instructions on how to learn to read ECGs. As I worked on this I soon realized how much work this would take and there are already lots of better resources out there to teach this. That's why there are a couple of posts on the basics of leads and background boxes which I thought I might as well post because maybe they will help somebody.
Currently I have broken it into two projects, one is complete and is the basic viewer where you can load an ECG and use the calipers and click buttons to help interpret it but has no "Quiz mode". I am trying to get it into an executable that will be more easily installed rather than having to have people install python and pygame to run it. For some reason I haven't yet gotten it to work, although I have done this in the past with another game I made (a multiplication game for my sister which I might put up here someday too).
The "Quiz Mode" version needs some work, because ideally I would like to make it so that the user can design their own quizzes. Currently I just have it set up with basic proof of concept quiz that I made.
I will be done with a week of nights this Monday and will have some days to tinker so hopefully I'll have the "Basic ECG Viewer" program available in a couple of days.
PS: Originally I had planned on incorporating detailed instructions on how to learn to read ECGs. As I worked on this I soon realized how much work this would take and there are already lots of better resources out there to teach this. That's why there are a couple of posts on the basics of leads and background boxes which I thought I might as well post because maybe they will help somebody.
Sunday, April 5, 2015
ECG Primer Part 3
The Precordial Leads (V1 – V6) measure the electrical
potential of the heart in the Transverse Plane (Gives you a “Z” axis,
think of it as looking down at the heart from above):
If you understand the anatomy of the heart you will see how V5 and V6 give a good measure of the lateral, left side of the heart while V1 and V2 cover more of the septal area.
By understanding where the leads are positioned and knowing the anatomy of the heart, one can better understand where a certain abnormality is occurring in the heart, and which artery is likely involved:
Finally, the Rhythm Strip is important because it gives you the most time in one lead for observing the Rhythm. Recall that the entire ECG is 10 seconds long. The rhythm strip gives you all 10 seconds of the chosen lead (in this case lead I). The other leads are being sampled sequentially: that is the first 2.5 seconds of I, II, III are recorded, followed by the next 2.5 seconds of aVR, aVL, and aVF, etc...
Later I will write about how to place the leads in real life and briefly touch on what “augmented” means, although as long as you know the direction in which the leads measure you will be able to interpret ECGs.
If you understand the anatomy of the heart you will see how V5 and V6 give a good measure of the lateral, left side of the heart while V1 and V2 cover more of the septal area.
By understanding where the leads are positioned and knowing the anatomy of the heart, one can better understand where a certain abnormality is occurring in the heart, and which artery is likely involved:
Finally, the Rhythm Strip is important because it gives you the most time in one lead for observing the Rhythm. Recall that the entire ECG is 10 seconds long. The rhythm strip gives you all 10 seconds of the chosen lead (in this case lead I). The other leads are being sampled sequentially: that is the first 2.5 seconds of I, II, III are recorded, followed by the next 2.5 seconds of aVR, aVL, and aVF, etc...
Later I will write about how to place the leads in real life and briefly touch on what “augmented” means, although as long as you know the direction in which the leads measure you will be able to interpret ECGs.
Subscribe to:
Posts (Atom)