I Want to be a Doctor

A studyblr to track my long winded journey into medicine. BSc Biomedical Science, Cardiff University UK .  21

[imafuckingdoctor]

How I studied Anatomy & Physiology

Anatomy:

I’ve said it before & I’ll say it again, Netter is one of a kind guys. It has helped me so much.

There’s also an app I used to have on my iphone, I think it was called essential skeleton. Any app/program would do, I especially love the virtual dissection tool because it helped me understand different layers so much better.

It can get a little overwhelming with the details but there’s usually a “clinical anatomy” or “applied anatomy” part in the end of every chapter, I prioritized that over everything else because of its clinical relevance and this has not only helped me in my rotations this year but also MCQs in academic usually target this area so .. you’re welcome hahah.

The lab is your best friend here, take advantage of every minute you have in there. Understanding is key so for example if I didn’t fully understand the action of a muscle, I’d pull the tendon & see what it does with my own eyes, what I’m saying is I never left the lab without understanding everything because anatomy isn’t one of those things you can just memorize.

If your school provides a pre lab learning guide use that, if it doesn’t make your own. Just don’t go into the lab not knowing anything because you will struggle, whereas if you go prepared it’s gonna help you out a ton, you’ll consolidate everything you know & basically be good to go.

So here’s what I did to learn an anatomy lecture: Before the class I’d read what we’re studying from Snell’s, then I’d take notes, attend the lecture, go home, go over everything from Netter & my apps (I considered that my pre lab work) and then the next day I’d go into the lab & sort of explain whatever we’re learning either to myself or to my partner. Et voilà, we’re done.

Physiology

This wasn’t really my forte, but here goes nothing.

As for physiology I found that textbooks don’t do it for me.

So what I would do before class to prepare is watch as many YouTube videos from different sources about whatever we’re studying. I could link all my favorite YouTube channels if you’re interested?

Then in class I’d pay FULL UNDIVIDED attention (physiology needs more concentration imo)

Then I’d get home and go through the material my school provides, I didn’t even make my own notes in physiology because it was ridiculously time consuming & I needed visual illustrations. Reading it was like passive studying, I couldn’t learn anything no matter how many times I read it.

But the one thing that I found helped me the most in physiology is answering a shit ton of MCQs, that’s the only way I could properly learn.

So my strategy for physiology was basically pay full attention in class & do a lot of practice questions rather than spend hours memorizing everything from a textbook.

For the anon who wanted this that’s pretty much everything I did regarding these two. Hope you found it helpful!

[healthforpositivebodies]

Reasons to exercise

The problem with exercising for weight loss alone, is that if you fail to lose weight, it’s tempting to quit because it’s ‘not working’. 

But there are SO many other great reasons to exercise, completely unrelated to weight loss!

1. Because it’s good for your heart!

Exercise improves your cardiovascular health, and helps you live longer. 

2. Because it keeps your strong!

Exercise helps strengthen your muscles, and helps you avoid frailty and injury as you get older. 

3. Because it’s good for your mental health! 

Exercise reduces anxiety and improves mood. 

4. Because it’s good for your brain!

Exercise has been shown to improve memory as we age, and decrease the risk of Alzheimer’s disease. 

5. Because it’s so much fun!

There are so many great ways to be active, you’re bound to find one you enjoy!

There’s are so many reasons to exercise that aren’t related to weight. 

So ditch the scale, and get your body moving for all the other great reasons!

[anatomyandcappuccini]

RE-PROGRAMMING YOUR MINDSET FOR SUCCESS

I feel like I have to share my pathway towards success with you because I spent all my life considering success as the very end of the journey when in reality you can have it all along the way. And I think that understanding this is fundamental, not only for your studies but also for your everyday life.

I’ll start by showing you a little example. During my long stay in Cartagena I had the occasion to do a few salsa dance lessons with some of my friends (yeah cliché I know) and as I was listening to the salsa teacher I kept telling myself that I was too rigid and not coordinated at all and that I’d look terrible dancing.

When we had to practice the moves I couldn’t keep up with the rhythm and honestly, I was a mess. The teacher even came to me to tell me that I was thinking too much about the moves!!

In that very moment, I thought: “ok Margot, now think you’re a latina goddess, you’re sexy and you’re a born-to-be a dancer”. As soon as I started telling this to myself, my moves completely improved. They got so much better that I was the only one in the group who was able to perform all the moves correctly on the first try.

What I want to tell you with this story is : you won’t go anywhere as long as you keep a negative mindset. The second you switch your mindset and you turn it into something positive, a little miracle happen. Just as me being able to perform good dance moves (and trust me that this one is really a true miracle :)

Now, I know it’s easy to say but I really want you to understand this because it’ll change your life like it changed mine : whatever you think about, you become.

The minute you start filling your brain with useless thoughts like “I’m not enough of this”, “I wish I had this”, “I wish I looked like that”, “I’m too fat to wear that”, “I have no self-control”, “I’m bad at maths”, etc. well guess what : you’ll still be bad at maths, you’ll stay sad and in months from now you’ll be stuck in the same place.

Here are some bits of advice about what you should be doing instead. Notice that this post is inspired by Gabrielle Bernstein’s book “The Universe has your Back” and also by other inspiring video’s I watched in the past few months :) 

Focus on your goal and imagine how you’re gonna achieve it, how you’re gonna feel and how proud you will be. Make it as clear as possible. Write it down in your journal if you want. Visualize every single detail. If your goal isn’t clear, it’s ok! You can still think about how you can improve your life or how you can work on just loving yourself more. And don’t be afraid to think big.

Practice positive affirmations. This one will be hard in the beginning because we all are used to focus on the things we don’t have, or the habits we want to get rid of, but we never pay attention to what we already have or why we really want success. Instead of thinking “I want to stop biting my nails so I won’t be ashamed of them” think “I’ll be so proud of myself if I stop biting my nails and I’ll feel more confident!”. Trust me, it makes ALL the difference.

Practice gratitude. You have no idea about the positive impact it has. If you struggle with this, try to make a list of at least 5 things you are grateful for every night before going to bed. Write it in a journal or just think about it for a moment. There’s no “wrong” way to practice gratitude. You can be grateful for the pizza you had today, or your cat. It just has to be positive.

Get some inspiration. Read a new book or look for some videos that inspire you. Get closer to people you admire. Inspiration is so important because it allows you to get a better view of what you want to become. I really started changing my mindset the first time I read “You Are a Badass” by Jen Sincero. It has been so eye-opening to me that I started practicing more and more positive actions ! I also found TED Talks to be really helpful for me!! 

Judge less. I know, we’re all humans. We all judge and it’s totally normal to do so. However, we can modify our judgment towards a lot of situations : whenever you notice yourself judging something or someone, take a step back and think why you are doing so, it’ll help you to see clearer and you’ll let more space for love. You don’t know what’s behind the people you’re judging and it doesn’t help you to reach your goal. Use this energy to work on yourself instead.

Stop comparing yourself. Don’t stop because you think you’ll never be enough. You don’t know what the others are going through, you don’t even know what they are thinking. I remember in my first med school year that I was constantly focusing on what the others were doing and comparing it to what I was working on instead. I spent so much energy doing so instead of studying that it made me fail my exams. And you know what the funniest part is? That the people I valued better than me failed their exams too. This definitely changed my vision! The next year I only focused on myself and on my own study methods and I passed all my exams :) 

Start where you are and celebrate small victories : you’ve been feeling like crap and all you did was taking a shower? It’s fine. You took care of yourself. Be happy about it. Be grateful to be able to do so. Don’t wait for the right moment to start something because the truth is that there’s no right moment and that you’ll never really be ready. Success is more about the journey than the destination. Always remember that.

Stay true to yourself. Don’t seek perfection but start loving every part of yourself instead. Don’t apologize for being authentic because it will allow you to understand what truly matters to you in every situation. Being your own self will also help you focus on your goal and not letting distractions around. You’ll gain confidence as you’ll know what works best for you and you’ll be able to let go of negative things in your life.

Also, don’t apologize for your success and your abundance. You are worth it. You’ve always been. 

I hope these tips will help you to reach your goals! You deserve to be happy and successful!

Margot X

[medically-challenged]

FREE MEDICAL PDFs

Anatomy:

1–> KLM for Gross Anatomy

2–> Snell’s Anatomy

3–> BD Churassia

4–> RJ Last

5–> Grey’s Anatomy

6–> Langman Embryology

7–> KLM for Embryology

8–> BD For General Anatomy

9–> Dissector

10–> Di Fore Histology

11–> Junqueira’s Histology

12–> Netter Atlas of human Aantomy

Folder link–> https://drive.google.com/open?id=0B3WdpdsqpX0LYV9KQ3lxY29FY28

Physiology:

1–> Guyton

2–> Ganong

3–> Sheerwood

4–> Sembulingam

Folder link–> https://drive.google.com/open?id=0B3WdpdsqpX0LdXlCSjdZM214dEE

  Biochemistry:

1–> Harper

2–> Lippincott

3–> Chatterjea

4–> Satyanarayan

5–> Stryer

6–> MRS Biochemistry

Folder link–> https://drive.google.com/open?id=0B3WdpdsqpX0Ld0o3WnhCR2VEczg

Pathology:

1–> Big Robins

2–> Medium Robins

3–> Pathoma

4–> Goljan

5–> Harsh Mohan Pathology

6–> Atlas of Histopathology

7–> Levinson

8–> MRS microbiology

9–> Microbiology by Jacquelyn G. Black

10–> Color Atlas of Microbiology

11–> Kaplan Pathology

Folder link–> https://drive.google.com/open?id=0B3WdpdsqpX0LYkRYdjFrTm5MR0U

  Pharmacology:

1–> Big Katzung

2–> Mini Katzung

3–> Kaplan Review

4–> Lippincott

5–> Pocket Katzung

6–> Rang and Dale’s Pharmacology

7–> Atlas of Pharmacology

Folder link–> https://drive.google.com/open?id=0B3WdpdsqpX0LMkE1UUVRZGwtTlU

Forensic Medicine:

1–> Simpson’s Forensics

2–> Krishan’s Forensics

3–> Atlas of Autopsy

4–> Atlas of Forensic Medicine

Folder link–> https://drive.google.com/open?id=0B3WdpdsqpX0LQXVwOGoyWnFSV2s

Ophthalmology:

1–> Jogi

2–> Jatoi

3–> Parson’s Textbook of Eye

4–> Kanski

5–> AK Khurana

6–> Atlas of ophthalmology

Folder link–> https://drive.google.com/open?id=0B3WdpdsqpX0LOHc5WVZMdkJjX2M

Otorhinolaryngology:

1–> Dhingra

2–> Logans Turner

3–> Color Atlas of Otorhinolaryngology

4–> Maqbool’s Text Book of ENT

5–> Clinical Methods in ENT by PT Wakode

6–> ENT at a Glance

Folder link–> https://drive.google.com/open?id=0B3WdpdsqpX0LaDY2a0lFNDlfTGc

Community Medicine:

1–> Monica’s Text Book Community Medicine

2–> Mahajan And Gupta Text Book of Community Medicine

3–> Bancroft’s Text Book of Community Medicine

Folder link–> https://drive.google.com/open?id=0B3WdpdsqpX0Lc1RCMml2NjhFNjA

Internal Medicine:

1–> Churchill’s Pocketbook of DD

2–> MTB Step 2 Ck

3–> Davidson Essentials

4–> Davidson Principals and practice

5–> Harrison’s Internal Medicine

6–> Internal Medicine USMLE Nuggets

7–> Internal Medicine on call bt LANGE 8–> Oxfords Specialties

Folder link–>https://drive.google.com/open?id=0B3WdpdsqpX0LeEFJNG5TMlc4eWc

Surgery:

1–> Bailey_love short practice of Surgery

2–> Churchill’s pocketbook of Surgery

3–> Deja Review of surgery

4–> Farquharson’s Textbook of Operative General Surgery

5–> Hamilton Bailey’s Physical Signs

6–> Oxford Handbook of Clinical Surgery

7–> Schwartz’s Principles of Surgery

8–> Macleod’s Clinical Examination

9–> Macleod’s Clinical Diagnosis

Folder link–>https://drive.google.com/open?id=0B3WdpdsqpX0LRFpFSG5hZ1pVWkE

Obstetrics & Gynecology:

1–> Case Discussions in Obstetrics and Gynecology

2–> Deja Review of Obstetrics Gynecology

3–> Obstetrics by Ten Teachers

4–> Gynaecology illustrated

5–> Gynaecology by Ten Teachers

Folder link–>https://drive.google.com/open?id=0B3WdpdsqpX0LMU1LRjFDa1FrbjA

Pediatrics:

1–> Nelson Essentials of Pediatrics

2–> Nelson Complete

3–> Pediatrics Review

Folder link–>https://drive.google.com/open?id=0B3WdpdsqpX0LUkdTQkVuNV92Yzg

I hope this helps everyone, it’s not mine. But has been shared to me and I am sharing this with all of you.

[notyourdaddy]

Gideon Mendel’s The Ward

Memories from the heart of the Aids crisis shows true love in a time of terrible tragedy.

These heartbreaking and incredibly moving images show the affection and love shown during the height of the Aids crisis. Photographer Gideon Mendel’s project The Ward began in 1993 when he spent a number of weeks on the Charles Bell wards in London’s Middlesex Hospital. All the patients on the ward were dying with the knowledge that there was no cure for the disease. During this time antiretroviral medications were not available and patients on the ward faced the prospect of an early death.

[iwanttobeadr]

| Change |

I think it’s time for a rebrand of this and my instagram

[mushstudies]

sooo basically my stationery-loving nerd ass has a tendency to over-buy when ordering, and so i have a few bits and bobs that I don’t really use??? I’ve been hoping to do a giveaway of some sort for a really long time, so i’m hoping to use this as a tester and maybe do another bigger one if it goes well !!

items in the giveaway:

cloud-shaped correction tape

two sets of page markers (blue + grey/beige)

three black-ink cactus pens

two marble-pattern washi tapes (one white, one black)

a set of small plant-patterned envelopes

although I initially ordered them for myself, I’ll just clarify that all items are unused and are in the condition that they were when I first received them.

how to enter:

reblog this post (likes won’t be included)

be following me (x)

thats ………………. literally it 

if you enter, please make sure that you’re either over 18 years old or have parents’ permission to give me your address (so that I can post it to you)

if all goes well and 10+ people enter, I’ll be ending the giveaway on tuesday 1st may 2018 and posting it asap once a winner is chosen w a random generator. the giveaway is open worldwide, but if you live outside of the UK, just be aware that I’m not sure how long shipping will take!

thank you !!!!

[mushstudies]

this ends tomorrow !!!!

[nursekrystaaal]

“I’m a doctor. We get all the glory. And credit. And guess what? We only deserve part of it. I started out in medicine in the mid-80′s, volunteering at an ER. And the biggest shock to me was learning how much of what happens in a hospital is nurse territory. Doctors will see you anywhere from 5 to 30 minutes a day, depending on how sick you are. And the rest is the nurses. They’re the ones making sure you get your pills and checking that your vital signs aren’t dropping. They make sure you don’t fall down and break something. If you start vomiting, doctors will run out of the room and the nurses will rush in. They change your wound dressings and start your IV line. They’ll bring you a warm blanket. And clean disgusting things off you. Even if you’re drunk. Or delirious. Or mean. And through all of this they try be friendly and positive. Even though you aren’t their only sick patient. I respect nurses. I learned early on that they’re key to being a good doctor. You piss off the nursing staff, and you’ll have a miserable career at that hospital. Respect and treat them well, and you’ll never regret it. They’re as important to being a good doctor as your medical degree. Maybe more. If you come out of medical school with a chip on your shoulder against nurses, you better lose it fast. Because they will make or break your training, and often know more than you do. Be nice and they’ll teach you. A good neurology nurse is often a better inpatient neurologist than some doctors I’ve met. I remember a guy named Steve, who was an intern with me a long time ago. We were only a few months out of medical school, and as we were writing chart notes one morning a nurse came over and asked if he’d go listen to his patient’s heart. With icy contempt, and not even looking up from the chart, he said “I don’t have to listen to his heart, because I looked at his EKG.” They ain’t the same thing, dude. If he’d listened he might have noticed that the patient had developed a loud murmur in the last 24 hours. When the attending caught it a few hours later, Steve got chewed out. If he’d taken the nurse’s advice, and listened, he wouldn’t have gotten reprimanded by the residency board. Here’s a quote from “Kill as Few Patients as Possible” by Oscar London, MD: “Working with a good nurse is one of the great joys of being a doctor. I cannot understand physicians who adopt an adversarial relationship with nurses. They are depriving themselves of an education in hospital wisdom.” Those doctors are also depriving themselves of friends. On a difficult day on call, sometimes all it takes is a sympathetic nurse to temporarily add you to her patient list, steal you a Diet Coke from the fridge, and let you cry on her shoulder for 5 minutes. It doesn’t make the day any less busy, but helps you absorb the punishment better. What got me started on this? While I was rounding this weekend, a grateful patient’s family brought the ICU nurses a box of donuts, and so the staff was picking through them. One said, “Oh, this kind is my favorite, it has cream filling.” And a patient in one of the rooms yelled, “Hey, babe, I got my own kind of cream-filled dessert in here! Come have a taste!” You say that to a waitress, and you’d likely get your kicked out of the restaurant. You say that to a co-worker, and you’d be fired and/or sued for harassment. You say that to a lady in a bar, and you’ll likely get a black eye. And what did the nurse do? In spite of the patient said, she went in his room, turned off his beeping IV pump, and calmly told him that he would not talk to her that way. And I admire that. Nursing is a damn tough job. And the people who do it are tougher. And somehow still remain saints.”

—

Angela Ar (via

theitunurse

)

This makes me feel good.

(via adenosinetriesphosphate)

[brain-heart-lungs-nurse]

Omg this makes this preggo nurse cry 😭

[medblrforlife]

++ credit where credit is due. Thank you to nurses, NPs, PAs, techs, and anyone I’m forgetting. 

[grshn]

a plain white image, with two lines of text reading ““easier said than done”” in dark grey, and “reminders about recovering from feeling down or from having a panic attack” in a horizontal gradient of light blue, pink, and green

A lot of things, especially when it comes to recovery, are easier said than done. That thought alone can discourage those who are struggling into not trying at all. However, a better way to look at the phrase “easier said than done”, is that being able to say those things is a very good start on the journey towards getting it done. This small series of resources is going to explore that idea.

Let’s take a look at recovering from feeling down or from having a panic attack. Like our previous post on loving yourself, and thinking positively, recovering after a hard time is something that everyone wants to do, and yet it is so hard to do, and so commonly absent. Negativity both online and within ourselves has become more increasingly present, which can heavily influence ourselves when needing to recover. It was because of this that the GRSHN was created.

Recovering from feeling down or from having a panic attack may be easier said than done, but please know that you can get there. So please, whenever you’re able, try your best to take small steps towards saying that, and then you can start working towards doing it. Here are a few small tips and reminders that might help. 

try your best to reach out for help or for someone to talk to when you need to, especially while you’re feeling down or panicking

talk to a family member, close friend, or other trusted person

if you’re unable to do that, please try your best to reach out to these international helplines

there are also online support chats available if you’re unable to call someone right now

take deep breaths – those will help you in clearing your mind or in regaining your focus

here is a written breathing exercise

you can breathe along with a gif here

you can also find guided meditations online, or through apps such as smiling mind (app store ♡ google play ♡ browser)

you can also try this grounding exercise if you need to regain yourself

it’s okay to cry, please let out the emotions that you need to

there is always hope, no matter how hopeless things may feel – you’ve gotten through everything that life has thrown at you so far, and you can get through this too

regaining yourself after feeling down or going through a panic attack can be extremely difficult, and a long process – please don’t rush yourself through this

be kind to yourself as best as you can

try to understand your negative thoughts and change them into positive ones – here’s some information about automatic negative thoughts and how you can work towards combating them

try to surround yourself with positive influences and think positively

take small sips of water in order to stay hydrated, especially if you have been crying

if you’re feeling nauseous after feeling down or having a panic attack, please try your best to stay hydrated, please remember to take deep breaths, and eat dry or bland foods, like plain toast or crackers, slowly – you’re going to be alright, this sickness will ease

if you’re feeling tired, please try your best to take a nap if you’re able to, even if it’s just for half an hour

take care of yourself - here are some tips on how you can to do that if you need them

celebrate every small success and step that you can take – even if all you can do is get out of bed, i’m proud of you for that and you should be proud of yourself too

try and stay active if you can, even if that is just standing up and doing some small simple stretches

give yourself time to recover, and take things at your own pace

things will get better

it’s going to be okay

I understand that the things above are “easier said than done”, but it is still important to say them, because that’s a start. 

If you have any tips or reminders you would like to share about recovering from feeling down or from having a panic attack, feel free to share them in your reblogs or replies.

I hope this could help, and I hope you have a lovely day today. :)

[studyblr]

your life can look so different, so much better, in just a few months. keep going.

[goodgirlwhoshopeful]

Just a PSA THAT TAYLOR SWIFT HAS ALREADY REACHED 1.5 MILLION SALES AND ITS NOT EVEN BEEN 24 HOURS but lol I forgot wasn’t Taylor Swift meant to be Over™?

[solsticestudy]

me: wants to be multilingual, a musical prodigy, an artist, an author, a poet, an honour student, working in a well-paying job, successful and happy

me: sits on my couch eating three(3) party-sized bags of salt and vinegar potato chips and watching thirty-one(31) episodes of my favourite tv show in one sitting

[iwanttobeadr]

This speaks to me on a spiritual level

[gentle-reminder]

gentle reminder

‪i know you want to help others when they need it, but please keep yourself in mind too; take care of yourself as much as you would take care of them, it’s okay to take a step back if you have things to deal with yourself first - they should understand that

[fatboystuntz]

She doesn’t have high standards she just knows what she deserves

[cwote]

Never forget your worth.

inspired by @amargedom

[iwanttobeadr]

GEM 2018 Entry Application

So I’ve done it I’ve applied for medicine 2018. 

My 4 choices are Southampton, Warwick, Newcastle and Queen Mary. 

It would be really interesting to get a group of us chatting about our applications and to support each other during this tumultuous time! 

If anyone has any questions about applying or anything please let me know!

Good luck to anyone else applying or studying towards applying to the future - it’s a tough old slog ahead of us!

[janedoemd]

ECG: quick and dirty

I’ve had countless sessions and lectures on ECGs. I don’t know how many websites I have bookmarked, or how many times my eyes glazed over reading Dubin. I’m also terrible at cardiology. I was on my way to accepting my fate of being horrible at ECGs forever, until I had a life changing session on ECGs taught by a great ER doc. I want to post it here because it was probably the most useful thing I learned in med school, and it will stick with me for the rest of my career. 

WHEN LOOKING AT ECGs FOR THE FIRST TIME:

1. One ECG is never enough. Always get old ones for comparison. If none available, do another one. Because. One ECG is never enough. 

2. RATE. Look at the number on top of the printed ECG. It’s stupid not to use that number. Yes, you should know the rule, 300-150-100-75-60-50. People say you shouldn’t trust the machine because… well, it’s a machine, and it can make mistakes. This is true. I don’t like to look at their “diagnosis” until I have gone through it myself. But the rate is just a number. Plus you should be able to eyeball it and be able to tell if it’s tachy, brady, etc. If the machine is telling you it’s 200 and if it looks tachy, then it’s probably the right number. 

3. RHYTHM. Is there a p-wave for every QRS and a QRS for every p-wave? Is the p-wave upright in lead II and down in aVR? Good. Done. BOOM. It’s sinus rhythm. ***if you cannot clearly see the p-waves then you cannot call sinus. move on.

4. AXIS. Again, look at the number at the top of the page. If it’s between 0 and +90, then it’s normal axis. If the number isn’t provided, or if your preceptor doesn’t believe in the convenience of machines/technology, look at the QRS complex of lead I and lead II. 

up in lead I, up in lead II: normal axis

up in lead I, down in lead II: left axis deviation (most common causes are left anterior hemi block and left ventricular hypertrophy)

down in lead I, up in lead II: right axis deviation (most common causes are right ventricular hypertrophy…PE)

5. did someone say HYPERTROPHY?

look at V1

is the R wave tall? (greater than 7mm?) right ventricular hypertrophy.

is the S wave tall? (greater than 11mm?) left ventricular hypertrophy.

  6. P-waves

look at lead II

is it wide? left atrial enlargement.

is it tall? right atrial enlargement.

7. PR interval

should be between 0.12 sec and 0.2 sec (3-5 small boxes). I used to always get this interval and QRS complex (less than 0.12 sec) mixed up. Think: atria depolarizing + shit getting to ventricles is gonna take longer than ventricles depolarizing. [2 things happening] versus [1 thing happening]. [0.12 sec-0.2 sec] versus [<0.12 sec].

long PR interval means there’s some sort of block at the AV node. 

1st deg block. PR interval is long. everything else is normal. cool. 

2nd deg block

type I: PR interval progressively gets long. eventually a dropped QRS.

type II: PR interval is constant, but randomly dropped QRS. 

3rd deg block “complete block”

there is no association between P waves and QRS. they run separately. **QRS does NOT have to be wide. Just look for P wave/QRS complex disassociation. I sometimes get this and 2nd deg type II mixed up. The only difference I try to remember is that PR interval is constant in 2nd deg type II, but is variable in 3rd deg. 

8. QRS complex

narrow or wide? 

narrow: good. signal coming from somewhere above ventricles. 

wide: think BBB (bundle branch block)

LOOK AT V1 ONLY.

if the last deflection of QRS is DOWN, then it’s a left BBB

if the last deflection of QRS is UP, then it’s a right BBB. super easy. no more of this bunny ears crap. 

9. ST segment

always look from J point, and compare with the isoelectric line of T-P segment (NOT PR interval). 

elevated/depressed… STEMI… duh. indicates ACUTE ischemic changes. 

look for reciprocal changes of the heart. if ST elevation in lateral leads, could see ST depression in the septal leads. PAILS:

posterior up, anterior down

anterior up, inferior down

inferior up, lateral down

lateral up, septal down.  

LBBB can look like STEMI. How to tell?

disconcordant changes is normal. (QRS and STEMI on opposite sides of the isoelectric line.)

concordant changes is abnormal. 

massive discordance is abnormal. (STEMI is greater than 5mm)

this isn’t that important. Moving on. 

Inferior STEMI. Could right ventricle be involved? 

DO NOT GIVE NITRO DO NOT GIVE NITRO DO NOT GIVE NITRO.

order a 15 lead

is STE in lead III > lead II? likely RV involvement

INFERIOR MI? 15 LEAD NO NITRO

INFERIOR MI? 15 LEAD NO NITRO

INFERIOR MI? 15 LEAD NO NITRO

10. T waves

is it inverted? indicates recent ischemic changes. 

11. Q waves

is it significant? indicates old ischemic changes. will likely be present if followed rule number 1 of reading ECGs. (1 ECG is never enough= look at old ECGs). 

I literally go through this list of 11 points in my head when I’m reading an ECG, regardless of whether or not I have an atrial flutter jumping at my face or if I see a massive anterolateral STEMI. Obviously I needed background knowledge on ECGs and the physiology of the heart before constructing this list, but this basic checklist has been very, very useful to me so far. It might look lengthy, but it doesn’t take a lot of time at all- a patient is not likely going to have all these issues with their heart. 

  Anyway. I still don’t love ECGs, but it feels pretty wonderful to be able to be able to evaluate it in a systematic manner, and get the theory behind interpreting the scribbles of an ECG reading. I don’t get these moments as much as I would like to, but it’s that crosspoint where my classroom learning actually meets real-life applications that gives me happy brain-gasms for days. I love knowing things and more importantly, knowing why.