Welcome to Practical ECG Courses

Practical ECG Courses are courses in ECG interpretation designed to cater specifically to clinicians working in the Emergency Department, especially senior level clinicians - Registrars & Consultants. It is a dream project of mine which is primarily based on how I wish someone taught me ECG interpretation during my early years in Emergency Medicine. 

While training in Emergency Medicine in India more than 10 years ago, I found a mentor in a Cardiologist who put in the time & the effort to teach me ECGs from the scratch. His style of teaching was unique - a concept based approach to ECGs, instead of learning things by rote or depending on pattern recognition alone. This changed my outlook to ECGs & gave me the necessary foundation to build reasonably good ECG interpretation skills & to further my ECG knowledge subsequently. Since then, there has been no looking back & I have been involved in organizing ECG teaching since 2014, initially with the aforementioned Cardiologist, & now independently for the past 5 years that I have settled in the UK. 

Over the past decade, I have noticed how even senior Emergency Physicians often struggle with ECG interpretation. I believe that a lot of this has to do with how ECGs are traditionally learnt, usually in bits & pieces at the bedside over the years. This is often supplemented with ECG workshops & other resources including reading books, online resources etc. While there are a lot of excellent ECG teachers out there, the ECG teaching often focuses on the general audience and therefore limits the teaching to that necessary for a MBChB/MBBS doctor. ECG workshops which cover the entire gamut of ECG topics in a day, while being very useful for a novice learner, are generally superficial and often inadequate for the requirements of a Specialist Registrar or Consultant level ECG interpretation. Senior Decision Makers (SDM) in ED should be experts in ECG interpretation given the high number of ECGs that we sign off every shift & the fact that ECGs often are the deciding factor in the decisions regarding patient disposition.  

But unfortunately, there are limited resources for Emergency Physicians looking to develop their ED ECG interpretation skills beyond the basic level interpretation. So over the past few years, I have put together a curriculum of sorts for what a senior level ECG interpreter in ED must know and developed courses based on it. Most of the courses utilises the concept based approach for almost all topics as this is the only way to really develop expert level ECG interpretation skills. But at the same time, the teaching is fully focussed on what is practically relevant in the ED. Hence my motto of "Simplify & Practicalize ECG Concepts". This approach to ECGs has been practice changing for me and I want to show the rest of the world that this can be done in the ED. All that it requires is some time & effort every now & then. 

I believe ECG interpretation is just like any other complex skill set that we learn in ED (Eg: Trauma resuscitation, Cardiac arrest resuscitation etc), it needs to be specifically learnt, practised & updated every couple of years. Because a lot has changed in the world of ECG interpretation in the last 10-15 years and unless you keep updated with it, you are soon outdated just like in any other area of medical knowledge. A significant number of senior clinicians are still unaware of how the interpretation of ischaemic ECGs have changed over the last decade. 

I have been organizing the Practical ECG Series for a while now & I have had great feedback from the delegates including the Registrars & the Consultants, some of whom attend it regularly. All the sessions so far have been conducted completely free of charge. While this is likely to change in the future, the current iteration of Practical ECG Series will be free till its completion. I would recommend you attend the free sessions & see for yourself. Feel free to join in for the sessions which may be relevant for you.

Looking forward to seeing you at the sessions.

Best wishes 

Obaid

What can I expect in these courses?

The USP of Practical ECG Courses is the concept based approach to ECG interpretation, rather than simply using pattern recognition to interpret ECGs. 

The aim of the teaching sessions is to develop strong fundamentals in ECG interpretation by understanding the various concepts involved and then utilizing those concepts for practical applications within the ED. In short, the ECG concepts are Simplified as well as Practicalized for its use in the ED.

• The concept based approach to ECGs has many advantages.

  • • Being able to understand what is going in the patient's heart, rather than simply looking for a diagnosis when interpreting ECGs. This is a very useful daily clinical practice because most ECGs we see routinely are nondiagnostic.

    • If you understand the concepts, then there is no longer any need to learn by rote the criteria for most of ECG diagnosis Eg: Sgarbossa, AV blocks, BBBs, Fascicular blocks etc.

    • Even in complex ECGs which does not fit into any known pattern to be able to make a diagnosis, you are able to glean information which can aid in decision making regarding treatment & disposition.

    • Lesser probability of errors compared with using only pattern recognition.

In addition to concept based approach, I also utilise the following for most teaching sessions.

• "Approach to ": Many ECG diagnoses have specific "Approaches" which are a specific order of steps in interpretation, which when utilized, helps interpret correctly and avoid errors. Eg: Approach to AV blocks, Approach to Tachyarrhythmias, Approach to RBBB etc.

• DD based approach to ECGs:  This a method of ECG interpretation where in you consider Differential diagnoses based on deflections and then use specific information to rule in or rule out the cause for the ECG abnormality.

• Lots of Tips & Tricks to help in ECG interpretation Eg: Identification of P wave (which may be surprising to some, but is in fact probably the most difficult bit in the interpretation of complex ECGs) etc.

While I am very passionate about teaching ECGs, my interest specifically lies in teaching concept based approach to ECG & not simply pattern recognition. My aim is to provide an online resource for senior ED clinicians who already have a base knowledge of the common ECG patterns and are looking to develop their skills further. The level of the sessions will be appropriate for Registrars & Consultants in ED and the teaching will be designed accordingly. There will be no esoteric discussions and every concept taught is carefully selected because of some clinical relevance that it has in ECG interpretation in ED.