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Competencies:

At the attending level, expert emergency and acute care physicians should proficiently interpret STAT ECGs to diagnose a wide range of emergent conditions—particularly those that are rapidly fatal. Mastery includes recognizing critical ECG patterns in the following “must-know” scenarios:

    • Occlusion MI and Acute Cardiac Ischemia
    • Unstable Tachydysrhythmias and Bradydysrhythmias
    • Hyperkalemia and Other Metabolic Emergencies
    • Toxicologic and Environmental Emergencies
    • Altered Mental Status Emergencies
    • Syncope & Post-Arrest Emergencies
    • Shock-Related Emergencies (including Pericardial Tamponade)
    • Cardiac Device Emergencies (Pacemakers, ICDs)

The Goals:

Attain expert-level pattern recognition, integrate ECG findings into clinical protocols immediately, and effectively teach nuanced interpretation skills to learners of all levels. This framework equips EM and acute care physicians to handle critical, time-sensitive cardiac conditions through comprehensive ECG education.

This following framework ensures that EM and acute care physicians are well-equipped to handle the critical, time-sensitive nature of emergency cardiac conditions through comprehensive ECG education.

Core Expectations

  1. Rapid Identification and Clinical Integration
    • Instantly recognize complex or subtle ECG findings and correlate them with patient presentation, risk factors, and hemodynamics.
    • Maintain a patient-centered approach: never interpret an ECG in isolation; always tie findings to the clinical scenario.
  2. Review "STAT ECGs: The Life Savers"
  3. Differential Diagnoses for ECG Abnormalities
    • Always generate a Must Know Differential Diagnoses list when encountering abnormal ECGs, particularly in unstable or high-acuity patients.
    • Reference critical ECG differentials to guide immediate management decisions, especially when history or exam findings are limited.
  4. Curriculum Development & QI Initiatives
    • Lead the creation and refinement of department-wide ECG curricula, ensuring clinical correlation is woven into every teaching module.
    • Spearhead quality improvement projects that enhance prompt ECG interpretation and streamline patient care protocols.
  5. Mentorship & Teaching
    • Provide expert guidance to residents, students, and interdisciplinary team members, ensuring they develop both speed and accuracy in ECG interpretation.
    • Foster a culture of continuous feedback and discussion around tricky or ambiguous ECG findings.
  6. Continuous Learning
    • Stay informed about emerging ECG research, literature, and evolving best practices.
    • Regularly review ECG Weekly Literature Reviews and incorporate weekly workouts into personal and departmental practice to maintain expertise.
  7. Periodic Assessments
    • Test and refine your interpretive skills via ECG Skills exams or simulation exercises.
    • Earn continuing education credits for completed modules and share results with colleagues to promote collective growth.
  8. Educational Leadership
    • Develop and oversee residency training modules that build on foundational knowledge toward expert-level ECG interpretation.
    • Mentor residents in producing scholarly work (posters, publications) focused on ECG interpretation or emergency cardiology.
  9. Research & Innovation
    • Initiate or collaborate on research projects that refine ECG interpretation methods, highlight new educational strategies, or improve clinical outcomes.
    • Integrate findings into department workflows, continually raising the standard of acute cardiac care.

 

Overview of the ECG Curriculum
Student/Paramedic Level

A place to start! Understand the basics of ECG waveforms, normal rhythms, and the importance of clinical correlation. 

PGY-1 (Foundational Resident)

Solidify a systematic approach to ECG interpretation, learn to identify life-threatening arrhythmias, and get introduced to the many different ischemia patterns.

PGY-2 (Intermediate Resident)

Continue building your skills with in-depth exploration of conduction blocks, subtle ischemic changes, toxicologic & metabolic ECG patterns, and advanced arrhythmias. 

PGY-3 (Advanced Resident)

Rapid recognition of more rare syndrome and complex clinical scenarios. Continue learning about difficult rhythms, and develop nuanced clinical integration of the ECG patterns you have learned for rapid decision making.

Attending-Level Mastery

Rapid pattern recognition, expert-level case discussions, and teaching strategies for mentoring the next generation of ECG experts.  

ECG STAT Vertical