What an ECG can—and can’t—tell you

In this dvm360 interview, Amanda Shelby, RVT, VTS (Anesthesia; Analgesia), explains that while an ECG is an essential tool for visualizing the heart’s electrical activity, it cannot confirm mechanical function or guarantee that the heart is effectively beating. She reminds practitioners of the importance of evaluating the entire clinical picture rather than relying solely on monitor readings.

Transcript

Amanda Shelby, RVT, VTS (Anesthesia; Analgesia): I'm super excited to be speaking at Fetch. My name is Amanda Shelby. Apologies for my appearance—I just got back from a massage. You know, self care is important. I am a registered veterinary technician in the state of Indiana and a VTS in anesthesia and analgesia, a title I’ve held since 2010. My background in academia, especially in anesthesia and analgesia, has given me years of experience that led to this achievement and beyond.

Today, I’m focusing on topics closely related to anesthesia, sharing clinical pearls that you can incorporate into your everyday practice. I currently serve as a Senior Content Creator and CE Coordinator for VETgirl. In previous roles, I built “Think Anesthesia,” an educational platform, and I’m excited to continue that journey both virtually and in person.

For those joining me live at Fetch, you’ll experience my lecture titled “ABCs for ECGs,” which will also be available on demand. The three primary takeaways include understanding the importance—and the limitations—of ECG monitoring. The key concept is that an ECG is only the electrical reflection of the heart; it does not guarantee mechanical or actual heart beating function. I hope you become more comfortable recognizing both normal and abnormal ECGs in sedated or anesthetized patients, as well as in ER scenarios.

Let me share a personal experience: when I was just six months into being a credentialed technician and still learning my craft in anesthesia at a university, I encountered a patient arrest under anesthesia despite a normal ECG reading. I noticed a drop in carbon dioxide levels—an insight that reinforced the idea that while monitors are invaluable, they only capture part of the patient’s picture. Thankfully, with the guidance of a supervising resident, I was able to manage the situation and learn a valuable lesson that has inspired me to improve my ECG interpretation skills.

Remember, while ECGs are wonderful tools, they have limitations. I hope you never have to learn this lesson the hard way, as I did.