QUESTION: How much time should the entry-level paramedic training program allot to ECG training, and how much should be rate and rhythm instruction vs 12-lead?
Our Expert Today is Marjorie Bowers, EdD, RN, Paramedic
Dr. Bowers has been involved in emergency medicine since 1968. Her wide range of experience includes emergency nursing, flight nursing, street paramedicine, and EMS education. Currently, she serves as a team member on both a federal Disaster Medical Assistance Team (DMAT) and a State Medical Response Team (SMRT). Dr. Bowers holds a doctoral degree in higher education from Florida State University and a Master’s Degree in Educational Leadership from Florida Atlantic University. She is a Florida certified paramedic and Registered Nurse. During her 26-year tenure at Indian River State College in Ft. Pierce, Florida, she received the State of Florida EMS Educator of the Year award, was an appointee to the Florida EMS Advisory Council, was chosen as one of only a few educators nationwide to serve on the Educational Standards Curriculum Revision Committee for the National Assoc. of EMS Educators and NHTSA. During this time, she also authored numerous self-studies for both EMT and paramedic programs and participated in successful state and national accreditation site visits. She currently is a team leader for paramedic program site visits for the Committee on Accreditation of Educational Programs for the EMS Professions.
Throughout her career, Dr. Bowers has assisted thousands of EMT and paramedic students to successfully complete National and State of Florida certifying exams. She has developed and delivered presentations at numerous local, regional, state, and national meetings and conferences.
That is a very good question and a very hard one to answer. The problem in answering this question is that paramedic programs vary significantly in length all across the US. Also, some students will pick up ECGs very quickly where others struggle and may never be really proficient in them.
You can probably teach basic rhythm interpretation in about 8-12 hours. That includes review of cardiac A&P. However, really learning ECGs takes practice. All instructors who have contact with paramedic students should quiz them from the time they learn rhythms until they finish the program.
At the beginning of the 2nd semester, we reviewed ECG interpretation from 1st semester and then completed all of the rest of the rhythms. Again, once or twice a week, they would have ECGs on quizzes and always on tests.
In addition, students had ECG assignments to complete in clinical and ride time each semester. They could use textbooks or ECGs of real patients. By the time they finished the program, each student had IDs probably close to 1000 ECG strips (in class, lab, clinical, ride time)
12 lead probably could be taught in about 6-8 hours if you are including recognition and treatment of MI and angina and mimics. That would also include initial training on lead placement or review of lead placement if the students had already been trained on that skill.
During this class, I think it is important to keep practicing strips. Making each student “walk” you through the process of interpretation is helpful also.
Then again, practice, practice, practice. Keep going over the 12 lead strips in class, lab, clinical, and ride time.
Obviously, these times are relative to how long your program is.
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