I opened it without difficulty this time. 

G
In a message dated 10/4/09 9:38:33 AM, medicnick@gmail.com writes:

 
Hi Lee,
It is there... try going to http://health.http://healthhttp://heahttp://hehttp://health where you will see the attachment linked at the bottom.

I don't like how Yahoo changed this... makes a mess of things. We usually hear from Gene with this complaint.

Cheers,
Nick

___________________
Nick Nudell
medicnick@gmail.med
(714) 699-3549


On Sun, Oct 4, 2009 at 09:18, Lee Richardson <LRichardson@LRichardson@<wbrLRi> wrote:

 

Nick, for some reason I do not see the PDF.
 
Lee
 
From: ekg_club@yahoogroupekg_c [mailto:ekg_club@yahoogroupekg_c] On Behalf Of Nick Nudell
Sent: Saturday, October 03, 2009 6:50 PM

To: ekg_club@yahoogroupekg_c
Subject: Re: [ekg_club] Heart widget





 
 
Please feel free to invite anyone with an interest in cardiac care to join the group. Even those who have been around a while will learn from participating here.

Thanks,
Nick

____________ ______
Nick Nudell
medicnick@gmail.med
(714) 699-3549


On Sat, Oct 3, 2009 at 16:43, CHad Nixon <chadnixon1@hotmail.cha> wrote:
 
Sounds good, I am trying to get Tim Phalen, to the group. He could be a good asset to the group and actual input on STEMI's.


Chad



To: ekg_club@yahoogroupekg_c
From: medicnick@gmail.med
Date: Sat, 3 Oct 2009 14:56:01 -0700
Subject: Re: [ekg_club] Heart widget

 
Hey Chad,
We fully encourage folks in the area of education however we do take a dim view of spam with immediate expulsion from the club. As long as your content is free and does not lead to selling of products or services I don't have a problem with sharing it here.

We would prefer to see your posts be related to EKG interpretation, interesting cases, and other useful information.

Thanks,
Nick

____________ ______
Nick Nudell
medicnick@gmail.med
(714) 699-3549



On Sat, Oct 3, 2009 at 06:51, Chad <chadnixon1@hotmail.cha> wrote:
 
Here is a cool heart widget from ecg solutions. Click on the leads to see the heart rotate to area. We are also developing an iPhone app with some cool features as well.

http://www.yourminihttp://www.yhttp://wwwhttp://www.yohttp://www.yo


 

 




Hotmail: Powerful Free email with security by Microsoft. Get it now.








 

Am an adult cardiologist, and not a pediatric cardiologist, but will try to
answer best I can -- but nowadays with how good echo is, pediatric
catheterizations are not used as frequently for diagnosis of congenital heart
disease -- usually echo and then maybe mri/ct will give you all the answers a
cath would without the invasive parts.

It is used for therapeutic cases -- can coil a small pda, or balloon a aortic
coarctation, and smaller procedures like that.

Lab tests to watch for are mainly the bleeding issue tests -- making sure the
INR is normal, platelets are good, and hgb is near normal. Since you are using
contrast, renal function needs to be normal, or you risk renal dysfunction.

In addition to the normal risks of catheterization, children are usually sedated
more heavily/general anesthesia for catheterizations -- so there are risks from
sedation as well.

Resources I found:

Here is a study from 1992 with the 3 year complication rate of pediatric caths
-- http://content.onlinejacc.org/cgi/content/abstract/19/6/1285

Google book on pediatric anesthesia:
http://books.google.com/books?id=ymuHmUWuUsAC&pg=PA124&lpg=PA124&dq=contraindica\
tions+of+pediatric+cardiac+catheterizations&source=bl&ots=R9czDWLBPZ&sig=uBBXyb6\
IeXbpS-RpewGFmdCuCv0&hl=en&ei=jATJSoHsDofIMOPvvfMH&sa=X&oi=book_result&ct=result\
&resnum=2#v=onepage&q=&f=false

If you have access to MD Consult, there is a section on pediatric catherizations
here:
http://cchs-dl.slis.ua.edu/clinical/cardiology/procedures/catheterization.htm
  Pediatrics Resources   See also General Pediatrics Resources

     * Park: Pediatric Cardiology for Practitioners 4th Ed.-2002 (MD Consult):
Table of contents - Health Sciences Library subscription ( INFO )
           o Chapter 7 - Invasive Procedures: Access document
                 + Cardiac Catheterization and Angiocardiography: Access document
                 + Catheter Intervention Procedures: Access document




--- In ekg_club@yahoogroups.com, haval surchi <havalandonlyhaval@...> wrote:
>
> No my dear, i want something which explains the indications,
contraindications, and complications of both diagnostic and therapeutic
catheterization of congenital heart diseases, (VSD, ASD, TOF... etc.)
>
> My friend is in pediatric department of the cardiac center, and he is new in
this field and just graduated from the medical college. During the preparation
of the child for catheterization, the nurses use to ask him about any abnormal
Lab results whether it will affect the catheterization or not.
> �
> Thanks
> �
>
> �
> HAVAL LUTFALLA
>
> --- On Sun, 10/4/09, Nick Nudell <medicnick@...> wrote:
>
>
> From: Nick Nudell <medicnick@...>
> Subject: Re: [ekg_club] Please, can any one send a paper on pediatric cardiac
catheterization
> To: ekg_club@yahoogroups.com
> Date: Sunday, October 4, 2009, 12:37 PM
>
>
> �
>
>
>
> Hi Haval,
> Do you mean for the repair or diagnosis of birth defects or are you looking
for information related to ischemic disease processes in children? Perhaps they
would be the same issue.
>
> Thanks,
> Nick
>
> ____________ _______
> Nick Nudell
> medicnick@gmail. com
> (714) 699-3549
>
>
>
> On Sun, Oct 4, 2009 at 10:29, haval surchi <havalandonlyhaval@ yahoo.com>
wrote:
>
>
> �
>
>
>
>
>
>
>
>
> Hi Friends
> � Please, i am a new resident in a cardiac center, my friend asked me to
provide him with a paper about pediatric cardiac catheterization regarding
indications, contraindications, complications and so forth.
> Thanks
>
>
> HAVAL LUTFALLA
>

Sent from my Verizon Wireless BlackBerry

Saves them money in terms of bandwidth and CPU power for their mail
servers though. So I can see why they'd go to that system. Still a
pain though.

On Sun, Oct 4, 2009 at 12:28 PM, Nick Nudell <medicnick@...> wrote:
>
>
> Hi Lee,
> It is there... try going to
http://health.groups.yahoo.com/group/ekg_club/message/12503 where you will see
the attachment linked at the bottom.
>
> I don't like how Yahoo changed this... makes a mess of things. We usually hear
from Gene with this complaint.
>
> Cheers,
> Nick
>
> ___________________
> Nick Nudell
> medicnick@...
> (714) 699-3549
>
>
> On Sun, Oct 4, 2009 at 09:18, Lee Richardson <LRichardson@...>
wrote:
>>
>>
>>
>> Nick, for some reason I do not see the PDF.
>>
>>
>>
>> Lee
>>
>>
>>
>> From: ekg_club@yahoogroups.com [mailto:ekg_club@yahoogroups.com] On Behalf Of
Nick Nudell
>> Sent: Saturday, October 03, 2009 6:50 PM
>> To: ekg_club@yahoogroups.com
>> Subject: Re: [ekg_club] Heart widget
>>
>>
>>
>>
>>
>> Please feel free to invite anyone with an interest in cardiac care to join
the group. Even those who have been around a while will learn from participating
here.
>>
>> Thanks,
>> Nick
>>
>> ___________________
>> Nick Nudell
>> medicnick@...
>> (714) 699-3549
>>
>> On Sat, Oct 3, 2009 at 16:43, CHad Nixon <chadnixon1@...> wrote:
>>
>>
>>
>> Sounds good, I am trying to get Tim Phalen, to the group. He could be a good
asset to the group and actual input on STEMI's.
>>
>>
>> Chad
>>
>> ________________________________
>>
>> To: ekg_club@yahoogroups.com
>> From: medicnick@...
>> Date: Sat, 3 Oct 2009 14:56:01 -0700
>> Subject: Re: [ekg_club] Heart widget
>>
>>
>>
>> Hey Chad,
>> We fully encourage folks in the area of education however we do take a dim
view of spam with immediate expulsion from the club. As long as your content is
free and does not lead to selling of products or services I don't have a problem
with sharing it here.
>>
>> We would prefer to see your posts be related to EKG interpretation,
interesting cases, and other useful information.
>>
>> Thanks,
>> Nick
>>
>> ___________________
>> Nick Nudell
>> medicnick@...
>> (714) 699-3549
>>
>>
>> On Sat, Oct 3, 2009 at 06:51, Chad <chadnixon1@...> wrote:
>>
>>
>>
>> Here is a cool heart widget from ecg solutions. Click on the leads to see the
heart rotate to area. We are also developing an iPhone app with some cool
features as well.
>>
>> http://www.yourminis.com/minis/yourminis/ECGSolutions/mini:ECGHeart
>>
>>
>>
>>
>>
>> ________________________________
>>
>> Hotmail: Powerful Free email with security by Microsoft. Get it now.
>>
>>
>
>
>

I looked and saw RBBB and then spent a few minutes trying to figure
out how on earth I could see flutter waves in the inferior leads but
not see them in the precordials! My questions is, since the cap is of
the left atrium (in orthoptic procedures) would this be Left Atrial
Flutter (Type 2)?

--
Christopher A. Watford
christopher.watford@...

On Sun, Oct 4, 2009 at 9:59 AM, medintern <erskine3@...> wrote:
> Saw this this morning while reviewing my emails. I think you may need to
register for Medscape to look at this ekg, but it is a pretty cool one --
especially for those of you who have not had experience with transplants.
>
> http://www.medscape.com/viewarticle/709589?src=rss
>
>
>
>
>
> ------------------------------------
>
> Yahoo! Groups Links
>
>
>
>

Saw this this morning while reviewing my emails. I think you may need to
register for Medscape to look at this ekg, but it is a pretty cool one --
especially for those of you who have not had experience with transplants.

http://www.medscape.com/viewarticle/709589?src=rss

 

Is there a list for physicians who are idiots? 

GG
In a message dated 10/4/09 1:17:27 AM, andrewj.bowman@gmail.com writes:

Because there are physicians who think the same thing. Of course I could also be mean and say it's because they are idiots.

Typed by my index finger and sent from my 〓 iPhone.〓

Andrew J Bowman
Acute Care Nurse Practitioner
Trauma Nurse Specialist
Paramedic

Witham Health Services
Emergency Department
Lebanon, Indiana
765-485-8500 Work
765-426-4189 Cell
765-485-8509 Fax

Clarian Arnett Hospital
Emergency Department
Lafayette, Indiana
765-838-5100 Work

Keeney Ambulance & Transport Service (KATS)〓
Staff Educator
Lafayette, Indiana


On Oct 4, 2009, at 1:56, ExLngHrn@aol.ExL wrote:



Recently, I've heard two different paramedics tell me that they don't run 12-leads on patients who have a ventricularpacemaker because "it won't show anything other than a paced rhythm."

I know from this list that you can see ST segment elevation and depression with a 12-lead ECG of a patient who has a ventricular pacemaker. How and why is that "urban legend" going around?

Thanks!
-Wes Ogilvie
-Austin, Texas

 

Recently, I've heard two different paramedics tell me that they don't run 12-leads on patients who have a ventricular pacemaker because "it won't show anything other than a paced rhythm." 

 

I know from this list that you can see ST segment elevation and depression with a 12-lead ECG of a patient who has a ventricular pacemaker.  How and why is that "urban legend" going around?

 

Thanks!

-Wes Ogilvie

-Austin, Texas

Thanks.  Sorry forgot to post my name.  I am..............

Just kidding.  I really appreciate what I have been able to read here so far. 
Every time I think I understand things I find another point I had never thought
of.  Thanks for letting me join.

Renny Spencer
The Idealistic Paramedic from the frontiers of west Texas

PS If Gene Gandy says anything bad about me don't believe him.  lol.


--- In ekg_club@yahoogroups.com, Nick Nudell <medicnick@...> wrote:
>
> Hi un-named mysterious new paramedic - ;-)
>
> I performed an experiment (no patients involved) with a fully consenting EMS
> provider. A standard 12 lead was attached using clean methods in the
> textbook locations then the subject was placed in several body habitus
> positions. In each position a 12 lead was acquired. The attached PDF
> demonstrates the results of this experiment. You may be surprised to learn
> how critical it is to maintain consistency in body positioning as well as
> lead placement and electrode attachment.
>
> When doing academic research I do fully cleanse the skin with an abrasive
> pad and a cleaning solution. Then the sticky purple stuff is applied to the
> skin followed by the electrode. An alternative uses a drill mechanism that
> spins the electrode into place abrading the skin as it does so.
>
> For normal work I don't think it is necessary to do this but clean and
> reasonably dry skin is good. You will find great variances in the quality of
> the tracing depending on the dryness of the skin, whether they used lotion
> or oils, if they are super hairy, etc. So it is a good idea to perform
> reasonable skin prep. Shave hairs and wipe off sweat/lotions/oils with
> alcohol based cleanser.
>
> After that make sure you put the electrodes on in the right places. I see
> way too many people who should know better putting them in crappy places. V1
> and V2 have to be in the right place, as do the other precordials. There are
> big differences in the action potentials of their locations - I can point
> you to papers on that topic if you don't believe me.
>
> Cheers,
> Nick
>
>
> ___________________
> Nick Nudell
> medicnick@...
> (714) 699-3549
>
>
> On Sat, Oct 3, 2009 at 14:15, spenair <spenair@...> wrote:
>
> >
> >
> > I have seen some just place electrodes w/o cleaning, shaving, etc and get
> > what appears to a decent 12/15 lead and I have seen others that scrub the
> > skin before placing the electrodes. I even was told that there was a study
> > that showed that really scrubbing the skin was proven to drastically improve
> > quality and accuracy of EKG's. As I am a fairly new Paramedic I would
> > appreciate your incite. Thanks.
> >
> >
> >
>

Sent from my Verizon Wireless BlackBerry

I have seen some just place electrodes w/o cleaning, shaving, etc and get what
appears to a decent 12/15 lead and I have seen others that scrub the skin before
placing the electrodes.  I even was told that there was a study that showed that
really scrubbing the skin was proven to drastically improve quality and accuracy
of EKG's.  As I am a fairly new Paramedic I would appreciate your incite. 
Thanks.

Thanks for the link.  Nice to help visualize.


--- In ekg_club@yahoogroups.com, "Chad" <chadnixon1@...> wrote:
>
> Here is a cool heart widget from ecg solutions. Click on the leads to see the
heart rotate to area. We are also developing an iPhone app with some cool
features as well.
>
> http://www.yourminis.com/minis/yourminis/ECGSolutions/mini:ECGHeart
>

Here is a cool heart widget from ecg solutions. Click on the leads to see the
heart rotate to area. We are also developing an iPhone app with some cool
features as well.

http://www.yourminis.com/minis/yourminis/ECGSolutions/mini:ECGHeart