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Faced with decreasing accuracy of STEMI recognition David took it upon himself to design a unique educational class to combat this. After hearing of a pig heart dissection class offered to hospital employees by a pacemaker manufacturer David began investigating the possibility of adapting the class for prehospital providers. Instead of focusing on anatomy as it related to pacemaker lead placement, the class was modified to teach anatomy as it related to myocardial infarction and 12-lead EKG patterns. Bringing together a team consisting of doctors, paramedics, and cardiac cath lab staff to teach the class allowed for a broad understanding of the various aspects of cardiac care.
Instead of the color coded picture that accompanies almost all EKG training material, the paramedics were able to dissect and visualize the actual internal structures of the heart to see which vessels feed the different parts of the heart and how it corresponds to ST elevation and depression. Additionally STEMI mimics were reviewed and explained from an anatomical perspective instead of expecting the paramedics to memorize EKG patterns. By memorizing, the paramedics were great at finding mimics that appeared exactly like the strips they studied. The addition of anatomical knowledge allows the paramedic to adapt and identify mimics that may not be straightforward.
While not directly related to STEMI recognition and care, elements of the original pacemaker training were included. Advances in pacemaker technology have evolved faster than EMS training on the subject and time was dedicated to educating them using the same concept of anatomy as the basis for learning.
To date, around 300 prehospital personnel have gone through this class and more are scheduled for the future. Due to the hard work of David and his team, not only has the accuracy rate of STEMI recognition increased, but the students have enjoyed themselves immensely. This program has been so well received; David has started planning a brain dissection class so the providers can better understand neurologic signs and symptoms.
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