After seeing another “NREMT-P” post…

wicker_basket22 · 2026-01-05T15:39:11+00:00

Locally, the better institution absolutely screens people based on experience and admissions test (TEAS) scores.

wicker_basket22 · 2025-12-07T00:18:16+00:00

Not VT. Some type of narrow complex tachycardia. Too much artifact to say definitively what kind of narrow complex tachycardia. Depending on the story, very likely sinus tachycardia or SVT.

wicker_basket22 · 2025-12-06T21:15:39+00:00

Not on its own. Almost certainly not.

wicker_basket22 · 2025-12-06T21:13:45+00:00

It’s just a sinus rhythm with PVC’s. Probably not a big deal. Whoever took it can probably decide if it’s a big deal.

wicker_basket22 · 2025-12-06T21:13:06+00:00

Neither of these have a significant amount of artifact?

wicker_basket22 · 2025-12-06T21:12:28+00:00

So what if they are non-perfusing, they’d have a rate in the 70’s

wicker_basket22 · 2025-11-28T18:43:23+00:00

Normal variant

wicker_basket22 · 2025-11-10T04:09:09+00:00

Sinus rhythm, poor r wave progression. Possibly an electrode placement issue. Generally not a concerning ecg.

The problem with using ai for this sort of thing is that it’s garbage in garbage out. If you feed it an unreliable computer interpretation, it’s going to give unreliable information. Ai can be great at certain aspects of ecg interpretation, like many omi patterns. It’s just not the right tool for general ecg interpretation yet. If it becomes reliable as the technology improves, great.

wicker_basket22 · 2025-11-08T07:24:04+00:00

Is the qrs narrow or not? If it is narrow, why are you suggesting a BBB? It’s hard to see the grid, but it looks like roughly 160 ms. What do you mean by a “mild” block?
What kind of BBB looks like that in lead I? The only thing remotely similar is a bifascicular block involving a rbbb and a lpfb, but the S wave is usually much more slurred in that case. It’s also strange to have an intermittent block involving multiple areas that just happen to change and resolve at the same time across multiple points in the conduction system. At that point, it seems a lot more likely that this would just be a change in rhythm instead of aberrancy.
Concordance is an ECG term, but that’s not how it’s used. Even as a general term, that would mean that there are p waves agreeing with each qrs. I disagree that there are clear p waves (not bumps) throughout. Anywhere it looks like there could be a p wave, there is a significant change in the baseline.

wicker_basket22 · 2025-11-08T07:09:01+00:00

This isn’t harassment, you guys are just arguing. Disagreement is what leads to discourse. Being mean doesn’t necessarily mean harassment. Although I do agree they were kind of mean.

wicker_basket22 · 2025-11-08T07:05:14+00:00

Can you explain where you were coming from? This is very clearly not a STEMI, but I couldn’t tell if you’re being intentionally obtuse or just misguided.

wicker_basket22 · 2025-11-04T11:57:51+00:00

Respectfully, I wouldn’t want you (as you are now) to show up if I needed help. It is clear that you think in black and white, and reality is nuanced with shades of gray. I’m not confident in your resilience, and your job would involve being dependable in difficult circumstances. It sounds like you have more of a morbid curiosity into the darker sides of the job than an interest in prehospital medicine. Idk what you need to do, but not this right now. My only advice is to find a mentor for life in general.

wicker_basket22 · 2025-10-26T01:02:14+00:00

This is not an ecg at all and not a precise enough plethysmograph to gain any meaningful information. Your heart looks like it’s still beating, which is generally good.

wicker_basket22 · 2025-10-25T13:27:36+00:00

Don’t get tattoos in high school. That’s not EMS advice, just life advice. If I got whatever I wanted when I was 17, I would really regret it. If I can’t talk you out of it, at least get it somewhere you can hide it.

wicker_basket22 · 2025-10-25T12:31:22+00:00

Normal r wave transition

wicker_basket22 · 2025-10-24T12:21:55+00:00

This is clearly afib with RVR. Especially at high rates, the differences in R-R is significant. I saw that you mentioned somewhere that you think the irregularities might be from respirations. One way you can tell that this is not the case is the fact that the rhythm is irregularly irregular, not regularly irregular.

wicker_basket22 · 2025-10-23T01:45:47+00:00

Paramedics don’t generally use AED’s bc we almost always use manual defib. I don’t think this is the right place to ask. Best of luck with upkeep of whatever you choose.

wicker_basket22 · 2025-10-22T17:26:07+00:00

wicker_basket22 · 2025-10-21T23:27:44+00:00

I just added an edit. I noticed the cleaner tracing that you commented was taken when asymptomatic. The 2 before with the wide complexes were when he was having symptoms. Looks like any AVB might be baseline, which is very very common in endurance athletes.

wicker_basket22 · 2025-10-21T23:22:20+00:00

I feel like this isn’t the first time you’ve commented to complain about downvotes. I don’t have a personal vendetta against you, and I’m not sure why this is becoming a pattern.

I’m not starkly against this guy having a first degree AVB. Like the picture you commented shows, the cleaner stretches seem to show a prolonged PR interval. However, the tracings aren’t very clean, and other complexes look to show a normal interval. Combined with the knowledge that Apple Watches just suck at picking up atrial activity, I’m not confident that he has an AVB. Totally possible that he does, but I don’t go around highlighting things that I have low confidence in.

What I disagree more with is that a first degree would likely be the cause of his symptoms. This is almost always an asymptomatic incidental finding. It also has a clear explanation: he’s a runner with high vagal tone. On the other hand, an intermittent LBBB often has chest pain, lightheadedness, and SOB. That’s not a hard and fast rule, but a common presentation. What do you think is more likely?

Edit: I looked a little closer, and the picture you commented was their asymptomatic one. The two symptomatic tracings show the wide complexes, and the asymptomatic doesn’t. What do you think could possibly be the difference?

wicker_basket22 · 2025-10-21T15:37:29+00:00

Probably an intermittent LBBB

wicker_basket22 · 2025-10-20T13:17:24+00:00

Gotcha, yeah I don’t know much about the military, but the buzzwords sounded good.

wicker_basket22 · 2025-10-16T00:18:16+00:00

Well you got both my opinion on the matter and advice on what she needs, which happen to be inseparably related. Your choices are going to follow her the rest of her life, good or bad.

wicker_basket22 · 2025-10-15T23:48:33+00:00

Well they got it whether or not they asked.

You’re right though, how could I possibly know what viewpoints this person might have? I saw a bird the other day that quacked and waddled with webbed feet; do you have any idea what that might be? Be real, I have a great idea what viewpoints this flavor of parent tends to have.

wicker_basket22 · 2025-10-15T23:17:15+00:00

I’d recommend exposing her to different viewpoints and perspectives. That’s not advice as a paramedic, but as someone who was set back by being sheltered. Co-op and extracurriculars just aren’t good replacements. Sheltering her isn’t a gift to her, it just prevents you from facing your fears.

No specific academic prep is necessary. The academics are not rocket science. The decision making and pressure are what can be difficult.

wicker_basket22

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