Written by: Dr. James Kelley
On any busy day in an emergency room, I wrestle with delivering accurate care in the presence of missing information. A typical day could involve the care of an elderly gentleman who suffers fainting and reports nausea, chest pressure and shortness of breath. His past history might include cardiac disease and a prior cardiac bypass. If new to the treating institution an EKG displaying an abnormality called a left bundle branch block raises immediate questions and concerns. The challenge…..is this bundle branch block new or old? The answer carries significant treatment implications. If new, this finding may result in a trip to the cardiac catheterization lab versus observation and monitoring if the finding is determined to be old. The typical scenario for most emergency physicians requires calling around town to doctor’s offices and outside hospitals in search of an old EKG. Carrying a copy of a prior EKG can significantly impact your emergency care. I suggest everyone do this, particularly if you have a history of cardiac disease or a known EKG abnormality. This can help your emergency care provider to provide better care.