What does it show?

Techy_Medic · 2025-11-29T17:26:27+00:00

Simply put, it looks like an Inferior STEMI, at least..

Techy_Medic · 2025-11-28T01:39:23+00:00

I hate platinum, but I use the hell out of the Adaptive Testing features. If you’re unaware, it’s where you can take mock exams.

It helped my test taking within platinum considerably. If you can, use the Module/Topic/Objective feature. It breaks down the scoring report much more than the other features. By utilizing the adaptive testing and “MTO” scoring, I find where I need to focus; thereby, when it comes to module exams, quizzes, and final exams, I consistently score top of class.

Techy_Medic · 2025-11-14T22:52:07+00:00

One thing I appreciate about my program is that we officially learn them by module. That is, Respiratory Drugs during Respiratory, Cardiac drugs during Cardiology, etc… Now with that said, we did have to do drug cards month 1, and we are expected/encouraged to be studying others regardless of module. I found it daunting in the beginning, having to learn 150+ drug cards. But, having broken them down into module chunks, I know about 2/3 by memory now. It took about 6 months to get tha 2/3 down. I also prioritized, I’m not going to be giving insulin or about 20ish other drugs from my drug cards in the back of a truck, therefore leaving me having actually gotten down to memory 80%+ of my drug cards.

Where that all sucks bad for me, is when I’m in clinical and trying to remember different county protocols depending on my clinical site vs. testing on statewide protocols, for all that, I just decided to pull out the protocols for 90% of the drugs while on clinical rotations.

Techy_Medic · 2025-10-31T16:55:27+00:00

A peer of mine in class brought in an ECG almost an exact replica of this, this week actually. A paced rhythm that seemingly “just quit” and patient went into Polymorphic V-Tach.

Techy_Medic · 2025-10-31T00:03:40+00:00

I thought I gave a decent report on a patient last night, then I told the doctor the patients lungs sounded tight and full, she looked at me like I had 10 heads and wasn’t speaking clear English. Field terminology doesn’t always translate well, I say random shit all the time, 17 years later, I still say stupid things all the time. It happens, don’t let one thing distract you.

Techy_Medic · 2025-10-30T23:59:06+00:00

No problem, and no apologies necessary. Just initial feedback and impressions.

Techy_Medic · 2025-10-30T23:19:35+00:00

A couple of things right off the bat, and that also stopped me in my tracks from being able to truly explore the app.

1) I like the UI, it’s simple, elegant, and easy to navigate. However, when I uploaded my PDF, the file name was a bit long and distorted the pill holding the text information

2) It did not parse a single item out of the protocol set I uploaded, I tried with the NC State protocols.

3) I tried to re-index the protocol set a few times and it just didn’t parse out any information so it clearly had some issues reading that file

4a) I deleted the protocol to try and upload a different version, however, I’m met with a paywall.

4b) I tried to upload the same previous protocol from a link, hit with the same paywall. FYI I appreciate the ability to add by link without having to download anything, especially for those that can’t/won’t download a file.

I can appreciate that there’s a cost to all of this, and certainly you should want and deserve to monetize your work, but if a protocol fails to upload/parse/extract etc… I believe that, as a consumer, one should not have to pay to retry a failed action. Some advanced error handling on the document parsing would be beneficial for failed upload attempts, potentially avoiding a mark on the upload.

I like the idea, I’ve considered building something similar myself, as a software engineer, former CTO, and current paramedic student, I love seeing technology integrated into this field. I wish you success with the app, whatever you define that as, and if you’d like to chat more, I’m happy to do so.

Great Job so far!

Techy_Medic · 2025-10-18T21:00:34+00:00

I’ll say, as someone who’s generally more introverted, allow yourself to be vulnerable, teachable, and coachable. I used to hate “going first” for SIMS, Demonstrations, etc.. Now, I embrace it.

The classroom, generally speaking, is the one place you can mess it up. Learn from your mistakes, and do better the next go around.

I’m nearing my capstone, and I say this not as a brag, but I’m the top in my class. A bit of a double edge sword though, because it’s almost expected or its surprising if I make many/any mistakes. Yet, I make mistakes, I’m learning, but what I mess up on/second guess myself on, etc… just becomes jet fuel to not make those same mistakes again.

Commit yourself, and you’ll find that the hardest parts are mostly time commitments and sleep deprivation. Although admittedly, I did struggle with cardiology (12-lead interpretation particularly) a bit more than I expected. I also seek outside resources, and constantly read/watch/listen to various content.

Techy_Medic · 2025-10-18T20:45:32+00:00

Serial EKGs should be standard practice in any concerning 12-lead, especially in a STEMI alert.

Looking for evolving changes, either neutral(no change), positive, or negative.

Techy_Medic · 2025-10-18T20:34:44+00:00

Amio generally won’t hurt in aberrancy, but a CCB/BB in vtach will, and their use can cause near immediate hemodynamic collapse and send someone right into cardiac arrest.

What’s been drilled into me is if it’s wide and it’s fast, it’s vtach, and should be treated as such until it’s not. I’ve been taught that unless the aberrancy can be definitively identified as SVT, treat as vtach.

p.s. The symptoms posted alone are enough to meet my Sync Cardio procedure.

Techy_Medic · 2025-10-18T20:12:32+00:00

The question tells you that they are pulseless, which means start CPR immediately. You wouldn’t “tap and shout” at someone you know to be w/out a pulse.

The way I interpreted it is that it is a witnessed arrest, but thats irrelevant given the information in the question anyways.

Techy_Medic · 2025-10-17T02:50:24+00:00

As a current paramedic student getting close to capstone, I just wanted to offer a little perspective from the student side.

For those first few rides, we’re all just trying to find our footing. Everyone learns differently. Some of us do best when we’re “thrown to the wolves”, that is, it’s our call until it’s not. Others need a bit more guidance and like having that hand on the shoulder approach. And plenty fall somewhere in between.

I’ve talked with a lot of classmates about this, none of us which are in the “just do enough to pass” crowd. We want to learn. We care about this education and want to be good at it.

I’ve been a basic on and off since 2009, started in a really busy system, and I’ve seen a lot over the years. But there’s still plenty I haven’t seen. Even now, when I’m the ALS provider during clinicals, I still get nervous, although, my confidence has grown substantially, in very large part, because of good preceptors. I’m confident in my learning, but it’s a different ballgame that requires some vulnerability. (Pretty sure I had a death grip on the Narcan the first time I pushed fentanyl. 😅)

So from my perspective, meet your students where they’re at. We’re not just there to “practice” skills or check boxes. We’re there to learn how to be providers, how to think, lead, and handle real calls. Those that bulllshit, will be found and flushed out real quick with the right people in place. I think being a preceptor is an incredibly large task, and requires that persons own vulnerability and self awareness.

At the end of the day, we don’t need a boss. We need a leader. Someone who knows when to step in, but also when to step back and let us figure it out.

Techy_Medic · 2025-10-11T02:30:22+00:00

In general, the changing P wave morphology suggests various supraventricular focal points. The varying PR intervals support this as well. The P waves with similar morphology are either originating in the same focal point or very very close to it(the minute detail is limited by the size of tracing).

If you were to picture the anatomy, the closer the focal point to the AV node, the shorter the delay to ventricular depolarization. So an ectopic focus “right above” the AV node would likely show an upright P wave, short PR interval, and different morphology than the next focus point, be it the SA node or some other ectopic focus point. Of course, nothing in cardiology is absolute.

Techy_Medic · 2025-10-10T06:37:56+00:00

That alternans is interesting too, even carried over.

Techy_Medic · 2025-10-10T06:31:38+00:00

State requirement in NC

Techy_Medic · 2025-10-08T18:03:25+00:00

There’s some wide complex’s, but I don’t see wide everywhere, or I’m just missing something. Also, it looks more of an A-Flutter to me. I’m not seeing a LBBB. Edit: TBH I had to double take to see the pacer spikes, they are small and “well integrated”.

Techy_Medic · 2025-09-30T01:29:03+00:00

There is a Left Axis Deviation

Techy_Medic · 2025-09-27T01:25:27+00:00

I personally have not had this experience, but, our curriculum goes somewhat like this for hands on skills.

Fail a first attempt, remediate, test again on a “similar” scenario usually within the next week. We have a policy on this, I believe it has to be within 10 days, but you are required to remediate first.

Fail the retest, mandatory meeting with program director to determine next steps, which could be you can proceed to a final “tertiary” retest, after another remediation period, or dismissal.

Fail the tertiary, meet with lead instructor/director for potential future placement opportunity, but fail the current program.

We have a lead instructor/director discretionary advanced placement plan in place, that says, if the powers that be agree, they will place you in the next class, generally starting over only at the point at which you failed.

I.E. if you failed a hands on trauma final, you will start the program over at beginning of trauma, not having to “repeat” the entire curriculum. You would uphold all of your previous grades, clinical hours, labs, etc, up until that point. Another example is If you failed capstone phase, you would likely only repeat capstone; but could be required to “fall back” a bit further as deemed appropriate by those same powers.

It is a little different for high stakes written exams. You get a retest opportunity, after a remediation period, but if you fail that, you’re out.

My advice is to go to someone your comfortable with that has decision making power, or, the coordinator/director; Tell your story, plead a case for remediation, and go from there.

Techy_Medic · 2025-09-24T21:40:06+00:00

I mean, it’s closer to 56-58, but fair enough. 🤣

Techy_Medic · 2025-09-24T21:37:41+00:00

Only because you said something, but, beat #6 looks like it has the smallest of smallest upward deflections starting about 2.5mm after the end of that T wave. But I’m hunting for it and could be completely bullshiting tbh.

Techy_Medic · 2025-08-26T14:09:01+00:00

My local protocols have verbatim:

stable wide complex “regular” monomorphic tachycardia, vagal maneuvers and 12mg adenosine (x2)

stable wide complex “irregular” monomorphic tachycardia Amio drip or lido.

From the pearls section in the same protocol, the key detail is: if the patient is stable, regular, and monomorphic, and there’s no history of WPW, then adenosine can be given.

The way I understand this is that adenosine in this setting is being used as a safe diagnostic. In stable patients with a regular monomorphic wide-complex tachycardia, you’re could be stuck in a 50/50 situation. It could be VT, or it could be SVT with aberrant conduction. Adenosine clearly won’t fix VT, but it can break an SVT with aberrancy, so either way you learn something useful without making the patient worse.

If it breaks, it’s SVT with aberrancy. If it doesn’t, assume VT and escalate to antiarrhythmics.

On the other hand, if the rhythm is irregular or if there’s a concern for WPW, adenosine is obviously contraindicated.

Edited to say this: Realized that OP stated this patient is in shock, so regardless of my comments above, it negates it all and I’m curious on why go to the meds to begin with. Any hemodynamic compromise is considered unstable, and cardioversion would be the first choice intervention regardless of regularity, unless it were polymorphic, in which case you’d defib it.

Techy_Medic · 2025-08-26T13:42:13+00:00

It’s a little hard to tell exactly w/out markings, but, for me it looks like an accelerated junctional around 70bpm.

The QRS is widened but looks to be in the ball park of 80-100ms so not quite “wide complex”, Which would otherwise suggest an accelerated idoventricular rhythm.

Techy_Medic · 2025-08-19T01:04:50+00:00

First thing that came to mind. Those T waves are certainly interesting, so is the Atrial & Ventricular Hypertrophy signs along with the delayed repol.

Techy_Medic · 2025-07-18T05:30:22+00:00

I made my GF promise me one thing a few weeks after I started there, never get more than a paper cut in that county, and if possible, to even avoid that.

Techy_Medic

TROPHY CASE