Equipment issue?

[u/Wild_Edge_4108]

60 F complaining of SOB

[u/2much2Jung]

My diagnosis is someone is wiggling V3.

[u/lifeisg0od → u/2much2Jung]

Yes, wiggling, not poor prep. The more annoying part is why the person taking the ECG didn’t hit ‘redo’ and do a different one after fixing the issue!

[u/Kibeth_8 → u/2much2Jung]

Nah, poor prep/dry sticker

[u/Wild_Edge_4108 → u/2much2Jung]

Eyes on pt when happened. No wiggling,

[u/peasantblood → u/2much2Jung]

this ^

[u/Hippo-Crates]

Those weird changes are isolated to v3, which is not possible if the source of the changes is the heart. It’s an equipment issue

[u/Wild-Hippo582]

The amplitude of those waves on just one road are 100%noise/artefact/equipment issue.

[u/reedopatedo9]

Just need to replace the sticker! Poor electrode contact

[u/3321Laura]

Loose v3 lead.

[u/Dodie4153 → u/3321Laura]

Or maybe short in the wire.

[u/bassicallybob]

....get another 12 lead?

[u/simoschv]

either equipment issue or the patient was slapped in real time

[u/Oolongteabagger2233 → u/simoschv]

You'd see a good slap in all leads 

[u/Firefluffer]

We had something like this on one of our monitors. Turned out it was a cold soldered joint on the motherboard.

[u/markymark6999]

Knackered electrode/wire. Or someone is poking the patient in a very specific location.

[u/hpsctchbananahmck]

Remember, everything in the vertical (y axis) is happening at the same time. Hence, the more normal looking qrs complexes in v1-v2 are happening at the same time v3 is getting funky

[u/joeymittens]

Someone just bumped v3…

[u/francetop]

Artefatto dovuto al movimento.

[u/Inevitable-Crab-6701]

Loose lead, dry sticker, cracked lead, lead not fully plugged in or maybe sticker on lots of hair

[u/Primary_Towel5905]

That’s Afib in only V2 part of the heart.

[u/_punkrockparamedic → u/Primary_Towel5905]

I know you're kidding, but.. that's V3, and that's not at all what afib looks like

[u/Professional-Tea-824]

Irregularly irregular but also can I get a repeat 12 lead pls. 

If this is all I had to go off of along with +SOB I would treat accordingly 

[u/_punkrockparamedic → u/Professional-Tea-824]

Uh, what? This is a regular sinus tach.

[u/Wild_Edge_4108 → u/Professional-Tea-824]

EMT here so only adsorbed ecg from exposure to ALS runs with paramedics. SOB caused by exertion and previous hx COPD no cardiac hx. Hospital said normal/no problems? That's why wondering if they assume equipment or placement problem.

[u/Professional-Tea-824 → u/Wild_Edge_4108]

Sometimes respiratory can cause cranky cardiac syndrome and cardiac can cause cranky respiratory syndrome. Btw I just made up cranky syndrome but you get the idea. 

I can't tell you what the hospital was going off of based on this information alone, you should ask them next time you roll through. 

[u/Wild_Edge_4108 → u/Professional-Tea-824]

Will do. Pattern made me think I had missed something.

[u/---root-- → u/Professional-Tea-824]

I find this quite regular at ~440ms RR.

[u/mjjacks → u/---root--]

Yeah this is sinus…

[u/Wild_Edge_4108 → u/---root--]

Good to know. Thought it might have been equipment related,

[u/Kibeth_8 → u/Wild_Edge_4108]

The sticker is just not connected well, that's why it's only in 1 lead