Medical Assistant Prep / Unit 23 MAS 570 review, 2 to 3 minutes
An Irregular Strip
The idea
This case is constructed for this course. It shows a medical assistant recognizing an irregular rhythm on a routine tracing, checking the patient, and reporting it promptly without naming it as a diagnosis.
In practice
During a routine physical, a patient's twelve-lead ECG prints with a baseline that looks wavy and slightly uneven. The medical assistant first rules out artifact. The patient is warm, relaxed and lying still, the electrodes are firmly attached, and no cords are near the cables. She records again and gets the same pattern. Looking at the rhythm strip, she sees that the distances between the R waves are never equal: the rhythm is irregularly irregular. She checks the patient, who is alert and breathing comfortably and has no chest pain, though he mentions feeling a fluttering sometimes. She counts the R waves on the six-second strip and multiplies by ten for an estimated rate. Then she takes the tracing straight to the provider. She reports that the rhythm looks irregularly irregular, gives the estimated rate, and passes on the patient's own words about the fluttering. When the patient asks whether something is wrong with his heart, she tells him the provider will review the tracing with him in a moment.
Where people slip
She recognized the pattern well enough to know it mattered, and she ruled out artifact first, because shivering and movement can mimic this rhythm. Then she stopped where her role stops. Naming the rhythm, explaining it to the patient and deciding what to do were the provider's work. Her prompt, accurate report, with the rate, the pattern and the patient's own words, made that work faster and safer.
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