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The preparation of this book is a joint effort between the transportation agencies of the United States, Canada, and Mexico. The Emergency Response Guidebook is used by emergency services personnel to provide guidance for initial response to hazardous material and dangerous goods incidents. While some people might say that kind of skill should require 13 years of preparatory school, four years of college, four years of medical school and a specialty in cardiac electrophysiology, I say…Pshaw!  It’s  not rocket science! An EKG is a graph (thusly named an electrocardiograph) tracing the strength and direction of this electrical signal. The journey causing this second contraction through the ventricles is represented by the QRS portion of the EKG. However, anything outside of the normal range is analyzed along with the patient’s symptoms to create a working diagnosis. To bastardize the words of Leo Tolstoy, who seemed to know a thing or two about the heart, “Happy [hearts] are all alike; every unhappy [heart] is unhappy in its own way”. It is very rare, but possible for an EKG to show a flat line, called asystole, when in fact the heart is still beating and producing a pulse.  It is because of this that it’s common practice to confirm death in a patient by looking for asystole in more than one lead.
Conversely it is also possible, and more common, to have an EKG show heart activity, and even normal sinus rhythm, after a person has died and their heart is no longer pumping blood.  This is called a PEA, pulseless electrical activity, and shows what is left of the heart’s intact electrical system after the muscle itself has failed.


The coffee stimulated brains of two nerdy paramedics with way too much time on their hands. I’m delighted you have cracked one of the greatest myths of all time, namely that medicine is not rocket science at all. Not to knock Doctors and their education, I am an EMT, and I would question how many Doctors could Actually pass an exam to become a Paramedic. Then your heart is firing backwards, which would hurt a lot because your basically having a heart attack.
Does anyone know if you have had a avib await ion if that would effect a major surgery like colon resection. Can I just say I loved the way this was written, because it was a lot more light hearted and not so serious with a quirky comment here and there keep me interested I picked this up quite fast, cardiac rehab exam is going to be a breeze!.
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This publication helps to provide consistent emergency response procedures for hazardous materials in North America, and is an essential tool for preparedness, planning and training. Or, to make a long story short, most healthy hearts pump blood through the body when stimulated by an electrical signal that travels along predetermined pathways.  This causes the cardiac cells to contract in just the right order, resulting in a magical four chambered pumping action. This signal then travels through the atria (the smaller and upper two chambers of the heart) causing them to contract and push blood in to the larger and more powerful ventricles below.


With perfect timing this signal continues through the Bundle of His.  The signal splits and speeds along down the left and right bundle branches, making its way to the Purkinje fibers and turning north again. Willhelm Einthoven in 1903, for which he received the Nobel Prize in 1924.  More impressively, he also had a triangle named after him. I’d say you have some flawed thinking to assume you have learned everything there is about the EKG in a day. Even a slight shift in any of the complexes, the time, the distance, can mean so many things. The genius method of the EKG is quite simple; however, it takes much more practice to be able to determine the many different cardiac pathologies by the reading of an EKG.
Doctors have an absurb amount of education and trust me when I say we know a lot more then you guys in most aspects.Even an EM doc failing a paramedic exam does not matter. Correlating what you see from the 12 leads to a full understanding of cardiac physiology, in coordination with the rest of human physiology of concern is what takes many years.



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