ECG Interpretation for Pharmacists

A Systematic Approach Pharmacotherapeutically Relevant ECG Findings

Facilitator: Dr.Peter Loewen, B.Sc(Pharm), ACPR, Pharm.D., FCSHP, R.Ph.

GOAL

Residents will have an APPROACH to interpreting 12-lead ECGs such that they can INDEPENDENTLY identify pharmacotherapeutically relevant findings to enhance drug related issue detection and drug monitoring.

This workshop forms the basis for residents to go out and PRACTICE these skills on their own. Like most things, only REPETITION will allow residents to use these skills in their own practice.

SESSION OBJECTIVES

Following the workshop and following personal reflection and practice, residents should:

Be able to readily list, in the correct sequence, the 6-step approach to ECG interpretation
Be able to approach any patient’s ECG and explain to another health care professional what they identify in each component of the 6 steps
Be able to explain to another member of the health care team the therapeutic relevance of each ECG finding. Examples of therapeutically relevant findings residents should be able to identify are:

Tachycardia, bradycardia, atrial fib/flutter, heart blocks (all 3 degrees), PVCs, PACs, QT prolongation, V.tach, myocardial ischemia/infarction, hyperkalemia effects, ventricular hypertrophy.

PREPARATION

Refresh your memory about what the various ECG WAVES (P, Q, R, S, T) look like and what they are indicating physiologically about what’s going on in the heart.
Review and have handy Loewen’s ECG Approach PLOP to see what the 6 steps are and to take notes on.
Have available this collection of ECGs we'll use to illustrate and practice the approach.

VALUABLE RESOURCES

Online

Medscape’s ECG of the Month: http://www.medscape.com/index/section_60_0
http://www.ecgmadesimple.com/
http://faculty-web.at.northwestern.edu/at/beaman/ecg/index.html
http://library.med.utah.edu/kw/ecg/
http://ekgreview.com/
http://cardioland.org/ECG/

Primary Literature

BMJ's "ABC of clinical electrocardiography" Series

Old-skool

Dubin D. Rapid Interpretation of EKG’s. 6th Ed. 2007. amazon.com
Dubin’s Rapid Interpretation of EKGs – the classic book, shared with you.

iOS Apps

ECGsource
ECG Guide
ECG Cases
EKG Academy
ECG Books
EKG Review
Many others (search the AppStore)