In this article, the author describes the creation of “The ECG Blog: Your PQRST-Needs Satisfied,” found at "ecgblog.wordpress.com,” and provides an interesting case study of differentiating ectopic atrial tachycardia from atrial flutter on ECG.

Background

I work as an ER nurse in the emergency department of Stavanger University Hospital, a large regional hospital in Norway. Although obtaining ECGs is a natural part of any ER nurse’s job, it is generally not expected that Norwegian nurses have any interpretive skills whatsoever. Some of course do, but most have gained their wisdom from work practice and self studies. ECG is hardly taught at all in nursing schools, unless one specializes within cardiac care nursing, intensive care nursing or within prehospital services. Even then, it is taught at a very basic level.

When I graduated as a nurse, those pink paper strips all looked the same to me. They reminded me of seismographic recordings or lie detector prints that I had seen on television: randomly scribbled lines, humps and bumps. Whenever I obtained an ECG and had the MD confirm it, I always thought it was amazing how these doodles could contain so much information about the patient’s heart and condition. Luckily, I’ve always felt the need to understand the things I do in order to do them well. That is why I quickly decided and felt obliged to learn the basic concepts of ECG interpretation. Working at the bedside of a patient is a great responsibility, and I felt unsafe not being able to read an ECG. Even though it is the doctor’s responsibility to confirm every ECG, I think it is very important that nurses know how to respond on the ECG that they’ve obtained from their patient.

I’ve had no formal ECG education; I’ve learned ECG interpretation by studying books as well as ECGs that I had xeroxed at work. I started this interest early in late 2006. While my enthusiasm was constantly growing, I became more and more frustrated that there were so few like-minded souls to exchange ideas with, learn from and discuss with. In order not to stagnate and to keep learning, I started searching the Internet for discussion groups, forums and sites where I could meet people who shared my interest for 12-lead interpretation. My first search on Google was for “ECG forum,” and the top result that was displayed was the forum for East Coast Guitars! I was disappointed and on the brim of disillusionment.

Creation of The ECG Blog

Even though there are a lot of Internet resources on electrocardiography and arrhythmia interpretation, I was struck by the fact that were so few sites that were open for discussion among their readers. What I needed was an arena where I could meet and discuss with fellow enthusiasts. I couldn’t find any forums or blogs that were completely dedicated to ECG interpretation that allowed discussions and comments. There was only one thing to do to fill this gap, so in October of 2008, I started The ECG Blog.

A blog is a good medium for presenting and discussing ECGs. First of all, most blog providers offer free hosting and several gigabytes of storage. This means that a large amount of high-resolution ECGs can be stored and presented. Threaded discussions allow users to comment and discuss each case. Additionally, maintaining a blog requires minimal skills, and the publishing is done with a few easy mouse clicks.