Thursday, September 04, 2008

I Gotta' Learn More
(Clinical Judgement)



There is stuff I kind of know a little about, and there is stuff that I really know. Take this EKG for example. To most folks it looks like a bunch of squiggles. Well, actually, that's what it is, however the pattern of this 12 lead EKG tells a story. When looking at it, it takes me about one millisecond to know that this is an inferior wall infarction (heart attack) in a person who has most likely occluded his/her right coronary artery. (There is also a minor right bundle conduction delay, but that is not clinically important). I see the whole thing in a flash...and it only took decades of study and repetition to do so.

Now, let's do the same exercise with this wave which I rode this past winter. I looked at it for a lot more than a millisecond and decided it was a good one to catch. Never mind that I was in a dry suit, the water was at freezing levels and the wave was headed into a small cul de sac full of chunks of ice. So out I went, turned, caught the sucker and began a thrilling ride. Unfortunately, I did not have decades of experience in such situations. Unfortunately I did not notice the crest of the wave catching up with me. Unfortunately I did not appreciate the significance of the bow going under. Unfortunately I pearled and was nearly ground up by the ice. Bad clinical judgment.
Reading EKG's is safer (and pays better) than surfing, and each can be life threatening if done improperly. In the case of the EKG some patient would suffer. With the wave only I could hurt myself. I really don't like either idea very much (although I could "live" with hurting myself a lot easier than I could with harming a patient).

So? So, I need a mentor and instruction and a lot of time "reading" waves. I need that clinical judgment that will help keep me out of trouble. I need to do a residency in surfing. I gotta' learn more about this stuff.

Paddle safe...
DS

3 comments:

JohnB said...

Me too!!!

Storm surf heading towards Tybee Island. Or, wanna meet out in the Pacific NW next month before, or after, my instructors class with Wilderness Medical Associates?

Some surf here today and tomorrow too--damn job!!!

ZonaNeff-U said...

Have you thought of testing your EKG reading skills while riding near-frozen surf?

Silbs said...

And risk icicles on my p waves?