I was sent a package earlier this week from the team at Medical Aide Memoire (MAM) (http://www.medicalaidememoire.com/) to take a look at their two most recent products; the ‘R-CAT Arrhythmias’ booklet and the ‘R-CAT STEMI’ booklet. As some of you may already know, MAM have been supporting us with prizes through some of our online CPD events, provided by both the @PreHospECG Twitter account, and the 12-Lead ECG: I’ve Got the Rhythm Facebook Group.
MAM themselves have certainly become more prominent on the twitter-verse, and many know them already as the creators of the ‘R-CAT Badge’ and the ‘R-CAT Window’. These devices are designed to be cheap, affordable, pocket-friendly rapid-cardiac analysis toolkits with the sole purpose of easing the electrocardiography evaluation of Heart Rate, ST Segments, PR, QRS, QT Intervals and Significant Q-Waves. I can certainly vouch for the fact that they are pocket friendly (the badge is the same size as the average ID badge or credit card) and the content provided is invaluable for anyone who is at the beginner-to-intermediate stages of 12-Lead ECG Interpretation. Both devices include a transparent reversible window with a solid red line, allowing for a more accurate comparison between ST-Segments and TP baselines; very useful when making an ECG evaluation for potential infarction & ischaemia, especially when one has not been exposed to a significant amount of ECGs in their experience.
Find the R-CAT Badge & Window here (http://www.medicalaidememoire.com/r-cat-badge.html & http://www.medicalaidememoire.com/r-cat-window.html)
So let’s have a look at their two latest products; the R-CAT Arrhythmia & STEMI Booklets. Both booklets are of exactly the same size, containing 12 double-sided pieces of laminated sturdy card, measuring approximately 17 x 8cm with a total thickness of 8mm (when completely folded). Having unfolded and folded the booklets several times now over the last couple of days, there seems to be no apparent weaknesses, and they both easily fold back into their original sizes each time. The laminated card feels sturdy enough to withstand the day-to-day activities of EMS, and the fact that they are laminated means that the booklets can be used as a versatile toolkit for teaching others ECG Interpretation & for making temporary notes.
The R-CAT (Rapid-Cardiac Analysis Toolkit) for Arrhythmias Booklet contains 41 six-second ECG strips that are calibrated to the exact size of a standard ECG printout; containing (not exhaustively) examples such as Atrial Flutter, Ventricular Pacing, Ventricular Tachycardia, Premature Junctional Contractions, Wolff-Parkinson-White (WPW) and PSVT. The rhythm strips are nice and clear on the eyes, of a normal calibration, black & white with red arrows to mark the important features, containing easy-to-understand notes at the bottom of each strip and enough variation to cover a wide range of ECG arrhythmia for analysis. The toolkit is not designed as a replacement for ECG Interpretation, but it certainly can assist the individual to make better informed decisions with the ability to make direct comparisons. The booklet also contains an edge to measure PR, QRS & QT intervals, as well as to assist in identifying potential Heart Blocks. There is also an edge simply for measuring the R-R intervals (using the large box method). I have measured both of these rulers, and they are as accurate as using a standard ruler or the ECG boxes themselves. I really like the look and feel of this booklet. I would certainly suggest purchasing this booklet to anyone that is at the beginner-to-intermediate stages of ECG Interpretation, to use as a rapid reference guide when looking at prehospital ECG traces that aren’t always immediately obvious. I would also highly recommend this booklet as an invaluable toolkit for teaching others, as it demonstrates a wide variety of arrhythmias that prehospital care providers may stumble across throughout their career. The ability to use dry-erase markers to make notes, and to better explain the key principles of rhythm identification is a clear bonus! I am really looking forward to using this device in the near future to help others in their learning journey.
Find the R-CAT Arrhythmia Booklet here: http://www.medicalaidememoire.com/arrhythmias-card.html Priced at the time of this article: £13.99 or £21.99 including the R-CAT Badge.
The R-CAT STEMI Booklet (Rapid-Cardiac Analysis Toolkit for ST-Segment Elevation Myocardial Infarction) is an accurate, informative, pocket-friendly reference guide for the correct identification of Acute Myocardial Infarction; giving further guidance to the localisation of infarct (and therefore suspected culprit coronary occlusion), correct electrode placement, anatomical views of the heart, explanations and examples of bundle branch blocks, and the importance of reciprocal change in Acute Myocardial Infarction (with examples). The traces within this booklet are extremely clear and accurately annotated. The images and diagrams are well designed and genuinely useful as a reference toolkit; both for personal learning and teaching others. As with the R-CAT Arrhythmia booklet, this guide is sturdy, laminated, and of the same size/specification. This booklet accurately demonstrates a variety of 12-Lead STEMI presentations – including posterior reciprocal changes during inferoposterior infarct. I would find this booklet extremely useful for teaching others ECG Interpretation in Acute Myocardial Infarction & Ischaemia – and again, I believe that anyone in the beginner-to-intermediate stages of their electrocardiography learning curve would find this an invaluable learning resource, as well as a useful quick reference guide. What I would love to see is the addition of the subtle changes in the very early stages of ACS, the ‘timeline of ST-segment changes’, hyperacute T waves, reperfusion morphologies and a variety of STEMI Mimics – but I also understand that this would be delving into what is sometimes deemed as the ‘more advanced stages of ECG Interpretation’ (debatable!) and this may be something that the team at MAM may want to consider as a future potential addition to their armoury. It would also be nice to have a section on the use of the posterior leads (V7/8/9) to confirm posterior infarct, and the use of the right-sided chest leads (most notably, V4R) when presented with an inferior MI to better guide the clinician to the consideration of nitrates. Having said that, I am really looking forward to using this booklet to demonstrate a variety of Acute MI 12-Lead ECGs to others. A well designed, easy to understand, clear and straight forward reference booklet for all.
Find the R-CAT STEMI Booklet here: http://www.medicalaidememoire.com/r-cat-12-stemi.html Priced at the time of this article: £13.99 or £21.99 including the R-CAT Badge.
Last but not least, a massive thank you to Medical Aide Memoire (MAM) for sharing these products with me for review. I hope to continue seeing your creations being involved in our future CPD events, and I wish your team all of the best in your future ventures. There is certainly a place for these badges and booklets to be used in the learning environment (mentoring, college, academy, university – to name a few!) and I am sure that any clinician in the beginner-to-intermediate stages of their ECG Interpretation learning and/or ability would find any of these devices invaluable in assisting electrocardiography interpretation in the prehospital phase of care; allowing for more rapidly better informed decisions, ensuring the best clinical outcomes.