Cardiac & ECG
Thirty-seven lessons on cardiac arrest, acute coronary syndromes, and ECG interpretation written for field acquisition. Topics include CPR quality, 12-lead timing, pacing, cardioversion, and rhythms that change the next action. Energy and drug amounts stay on local protocol.
37 lessons
Each lesson is 15 minutes or less, including a self-check drawn only from that lesson. A passed quiz is saved on this device.
Systematic ECG Approach
10 min
A six-step ECG method under time pressure: rate, regularity, P waves, PR, QRS, then an action for the crew — not a contest to name the rhythm.
Start lesson →AV Blocks: Three-Question Path
12 min
Distinguishing first-degree, Mobitz I, Mobitz II, and complete heart block with a three-question path, with pacing-ready thinking for high-grade block.
Start lesson →Stable vs Unstable Tachycardia
12 min
Perfusion, not the number on the monitor: when tachycardia means shock, altered mentation, or ischemic pain versus a stable rate-control or vagal/adenosine path.
Start lesson →Wide-Complex Tachycardia: VT vs Mimics
12 min
Regular wide-complex tachycardia treated as VT until proven otherwise, plus hyperkalemia, paced, and pre-excited AF traps — and when adenosine is not appropriate.
Start lesson →PEA: Without a Pulse
10 min
Organized complexes without a pulse: name PEA, continue high-quality CPR, and search for reversible causes that can be treated prehospital.
Start lesson →Asystole vs Fine VF
10 min
Confirming true asystole versus fine VF: gain, a second lead, pads seated, and not calling death on a technical problem.
Start lesson →ROSC & Post-Arrest Care
12 min
After return of pulses: airway and EtCO₂, oxygen and blood-pressure targets, 12-lead, temperature, and a destination that can complete post-arrest care.
Start lesson →12-Lead STEMI Recognition
12 min
When ACS is suspected: a 12-lead within about 10 minutes of first medical contact, territorial STEMI thinking, transmission language, and PCI destination.
Start lesson →Symptomatic Bradycardia
10 min
Bradycardia with poor perfusion: airway and breathing, pads applied, atropine versus pacing, and not delaying care for a rhythm argument.
Start lesson →Shockable Arrest: VF & pVT
10 min
VF and pulseless VT: early defibrillation, immediate CPR, minimizing pauses, and the two-minute cycle.
Start lesson →High-Quality CPR
10 min
Measurable CPR: 100–120 compressions per minute, depth, recoil, short pauses, 30:2 versus about 10 breaths/min with an advanced airway, and why mechanical devices are not routine.
Start lesson →SVT & Adenosine Framing
12 min
Regular narrow-complex SVT: vagal maneuvers, adenosine if stable, synchronized cardioversion if unstable — and why this is not atrial fibrillation.
Start lesson →Atrial Fibrillation with RVR
12 min
Irregularly irregular AF with a rapid rate: cardioversion if unstable, rate control if stable and protocol allows, and never treating AF with adenosine.
Start lesson →Hyperkalemia ECG Recognition
12 min
The hyperkalemia ECG: peaked T waves, wide QRS, sine wave, calcium for membrane toxicity, shifting agents per protocol, and a dialysis-capable destination.
Start lesson →Right-Sided & Posterior MI
12 min
Inferior MI plus V4R for right-ventricular involvement, V7–V9 for posterior occlusion, and nitroglycerin caution when the right ventricle is the pump.
Start lesson →Pit-Crew CPR
10 min
Assigning roles, switching compressors about every two minutes, applying pads while compressing, and keeping pulse checks short.
Start lesson →Transcutaneous Pacing in the Field
10 min
Unstable bradycardia and transcutaneous pacing: pads, rate then output, mechanical capture as a pulse with each paced beat, and sedation only if protocol allows.
Start lesson →Synchronized Cardioversion in the Field
10 min
Unstable SVT, AF, or VT with a pulse: confirm synchronization, energy per protocol, and not defibrillating asystole or PEA.
Start lesson →Double Sequential Defibrillation Framing
10 min
Refractory VF after standard shocks: AHA 2025 does not establish DSED or vector-change as routine — only if protocol includes it, never instead of CPR and the first shock.
Start lesson →Termination of Resuscitation
10 min
When to stop resuscitation: BLS/ALS/universal TOR rules, medical control, hypothermia and toxin exceptions, and documenting times and family communication.
Start lesson →Hypothermic Cardiac Arrest
10 min
Severe hypothermic arrest: gentle handling, delayed medications and shocks as protocol writes, and a rewarming destination — not scene TOR in the driveway.
Start lesson →Cardiac Arrest in Pregnancy
10 min
Maternal arrest: left uterine displacement, high-quality CPR, standard defibrillation, and that resuscitative delivery is a hospital and system skill.
Start lesson →Opioid-Associated Cardiac Arrest
10 min
Pulseless suspected opioid overdose: CPR first; naloxone only if it does not interrupt compressions. Pulse plus apnea is a ventilation problem.
Start lesson →Cardiogenic Shock in the Field
10 min
Pump-failure shock: pulmonary edema, hypotension, ACS as a trigger, no trauma-style fluid loading, and a PCI-capable destination.
Start lesson →Aortic Dissection: Field Suspicion
10 min
Sudden tearing pain, pulse deficit, or neurologic findings: pause the ACS reflex (nitroglycerin and preload-dropping fluids) and go to a center that can repair an aorta.
Start lesson →STEMI Equivalents
12 min
Patterns that should still activate: hyperacute T waves, de Winter, Wellens, isolated posterior, and uncertain LBBB or paced rhythms — transmit and treat as STEMI until proven otherwise.
Start lesson →Pre-Excited AF (WPW)
12 min
Irregular and very wide QRS: possible pre-excited AF. No AV-nodal blockers. Unstable means synchronized cardioversion; protocol owns any stable medication.
Start lesson →LVAD Emergencies
12 min
LVAD on scene: listen for the hum, assess MAP and mentation, restart the controller, and start CPR only if the patient is truly lifeless per AHA LVAD framing.
Start lesson →Defibrillation Pads & Vector Change
11 min
Anterolateral pads with a true cardiac vector, clear of breast tissue, and anterior-posterior vector change only after failed shocks if the system allows it.
Start lesson →ACS Without Chest Pain
12 min
Anginal equivalents — dyspnea, fatigue, nausea, epigastric pain — especially in women, older adults, and diabetes. Obtain a 12-lead within 10 minutes of first medical contact.
Start lesson →Serial 12-Leads in ACS
10 min
A nondiagnostic first tracing plus an ongoing ACS story: serial 12-leads, transmit both, and do not close the case on a single ECG.
Start lesson →STEMI Mimics in the Field
12 min
Early repolarization, LVH strain, pericarditis, LBBB, and paced rhythms versus true occlusion. Reciprocal depression is not a mimic. If uncertain, transmit.
Start lesson →Pediatric SVT vs Sinus Tachycardia
11 min
Infant rates often ≥220 in SVT versus sinus tachycardia with P waves and variability. Unstable patients receive electricity per protocol, not a prolonged sinus lecture.
Start lesson →Lead Misplacement and Artifact
11 min
Limb-lead reversal and artifact can fake infarction or VF. Check the cables and the pulse before a shock or a STEMI decision.
Start lesson →Sodium-Channel Blocker Toxicity
12 min
Wide QRS, tall R in aVR, and a sodium-channel blocker on the med list. Support the airway and the pressure. Bicarbonate only per protocol.
Start lesson →PE and Right-Heart Strain on ECG
11 min
Right-heart strain on the ECG supports possible PE. It does not prove a clot and it does not clear one. Oxygen, a 12-lead, and destination still matter.
Start lesson →Pacemaker and ICD Emergencies
12 min
Pacemaker spikes without a pulse, or an ICD that keeps shocking: treat the rhythm you see. Keep pads off the generator. Magnet use is protocol-specific.
Start lesson →Apply It Interactively
CardioStrip
Practice these cardiac lessons on 6-second Lead II strips and teaching 12-leads — STEMI patterns, occlusion warnings, extra leads, and mimics.