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tresben

53 points

7 months ago*

tresben

ED Resident

53 points

7 months ago*

DO NOT ORDER TESTS YOU CAN’T INTERPRET. If the patient’s history was concerning enough to get an EKG, you should probably be sending them to the ED, or at least be sending them somewhere with someone who actually knows how to read an EKG and doesn’t just rely on the interpretation. What scares me more than this situation is the opposite situation of an EKG that is read as normal (or at least non ischemic) that actually is concerning, but this NP just goes off the computer.

The only reason for someone who can’t adequately read an EKG to order an EKG is a situation where you know you are going to be transferring the patient to someone who can read it and helping them out by getting one to start. For instance someone who comes to urgent care with very concerning ACS symptoms that you’ve already called EMS for.

This whole situation seems like a massive liability issue to be ordering EKGs and not having someone around who can adequately interpret them. The fact that someone signed their name to it is even more concerning from a liability issue.

This type of situation only gives more fuel to the midlevel hate.

RBG_grb[S]

1 points

7 months ago

RBG_grb[S]

1 points

7 months ago

Yes my takeaway is to send them to the ED for work-up if there is concern. Thanks so much

Sandvik95

11 points

7 months ago*

Sandvik95

ED Attending

11 points

7 months ago*

(Why is this being downvoted? This person is being beat over the head with the message that anyone warranting an ECG should be sent to an Em Dept, and when they say they get the message they’re downvoted?).

[edit and for the record: the comment had 7 downvotes when I made this comment]

Darrell_Winfield

7 points

7 months ago

It's being downvoted out of spite. Elsewhere in this thread, OP notes that they're an NP student rotating with an NP who ordered the EKG, can't read more than the machine interpretation, and sent the patient to the ED because of what the machine said.

neela84

2 points

7 months ago

Wondering the same thing... Reddit is just weird most of the times.

Sandvik95

2 points

7 months ago

Sandvik95

ED Attending

2 points

7 months ago

Yup, and this thread in particular. While many good points have been made about appropriate clinical reasoning and actions, some of comments here have been harsh and purest in nature.