When ECG’s Go Horribly WRONG!
Before I begin telling you about today’s events, I’ll need to explain a couple of abbreviations to the non-medically minded amongst you.
SVT – supraventricular tachycardia (bloody fast heart best)
MI – myocardial infarction (heart attack)
ECA – Emergency Care Assistant (my glamorous assistant)
ECG – electrocardiograph (squiggly lines that tell us what your heart is doing)
AED – automatic external defibrillator (shock box)
Ok, so, today was a day like every other, it started of with the usual vehicle check and coffee before admitting to the control room that we were indeed ready to rock.
Our first job was a lady complaining of central chest pain (it always gets a high priority in case it’s an MI) so off we go forcing our way through the morning commuters.
On arrival at the patients address we were met by a pale, sweaty, generally poorly looking lady, my ECA started unpacking the equipment and running tests while I gathered the history, she stood on the sats probe (the device we use to measure pulse and blood oxygen levels) and broke it, no matter, we can still get a pulse manually and a heart rate off the ECG.
“Fuck, that’s fast” I thought to myself, and confirmed on the monitor that she was in SVT, her pulse was about 160.
I rang the hospital and told the doctor what I’d found, we blue lit the patient in, the nurse performed an ECG on their equipment but it was normal… ok so it might have rectified on the way in, stranger things happen at sea.
Patient number 2, a 17-year-old with a chest infection and chest pain, probably from coughing but we’ll do an ECG just to be sure. Shit. SVT. Heart rate of 170. Pre-alert the hospital and again on arrival, normal ECG… “this is weird” I said to my crew mate, but no matter, the radio bleeps and we’re off again.
Patient number 3, a middle aged man who’s had a faint, it’s possibly cardiac so we need to do an ECG… what?! SVT again?!? Something weird is going on here.
We took him into hospital with an abnormal ECG, his pulse rate felt around 80 but the ECG said 165, we didn’t pre-alert this time, something odd was going on.
We booked the patient in and returned to the ambulance. I told my ECA to wire me up, I wanted to check the machine on myself. SVT.
Now I know something’s definitely wrong. I rang the supervisor who, naturally, couldn’t possibly take my word for it so had to come down for a look.
Checked the machine and identified the fault.
It was a training unit.
Set to display SVT.
The ambulance had been used for a demonstration the week before but hadn’t been re-kitted. The training units used by my service are fully functional units, but are reprogrammed to display a set or changeable heart rhythm, it’s impossible to tell unless you take the batteries out and look for the red dot next to the serial number.*
It would still function as an AED but would always display SVT on the ECG.
I felt like an utter knob. Now I have to go back into the hospital with my tail between my legs and tell the lead consultant that the ECGs were… unreliable… and why.
*all training units have now been fitted with a bright orange handle and a sticker with the words “for training use only” at the top of the screen.