In Praise of Tim Phalen

If you ever get a chance to take a 12-lead class from Tim Phalen, Don’t miss it. Tim has been teaching 12-lead classes across the country for over twenty years. I first took a class from him about that long ago. He is a great presenter with the gift of making complex concepts seem easy.

When I first took his class, he told a story about Elvis the janitor, who he and his buddies taught how to read 12 lead ECGs. Elvis would be mopping the ED floor and then peer over the shoulder of a medical resident intently studying a new ECG. “Inferior MI,” Elvis would say, and then continuing mopping. A few hours later, he would glance at another ECG the resident had just obtained. “Anterior.” And back to the mopping, He became a legend in the ED for his savant-ability to read ECGs. How did he did he do it?

Simple. Tim and his buddies taught him Big and Tall is Bad. Lower corner is inferior, The right side of the page is Anterior.


Phalen, of course, teaches to a level of detail far greater than Big and Tall is Bad, but if through simple concepts he can teach a medically untrained janitor to recognize a STEMI, think of how effectively he can teach a paramedic to recognize a patient with a left bundle branch block who is also having a STEMI.

I’ve bought several of Tim’s ECG books over the years, mainly to replace ones I’d lend out that got relent and never returned. His books are well done, easy to learn from, and well worth the price.

I was excited recently to learn that Tim would be presenting a 12-lead class at our service.

In EMS, we sit through so many presentations that are dull and boring. Death by PowerPoint. I’ve been guilty of it myself. Watching Phelan is watching a master. His ability to keep things simple, and to circle back with repetition so the key points sink in is masterful.

Since the audience was experienced medics, he focused on more advanced concepts rather than an introduction to 12-leads in the three hour class he gave us. The STEMI equivalents and the imposters. I had heard of Wellen’s sign, DeWinter’s T waves, Brugada Syndrome and Scarbossa before, but I understand them much better now. He also covered Left Main Equivalent/Triple Vessel Disease, post ROSC ECGs, as well as Left Ventricular Hypertrophy, Bundle Branch Blocks, Early Repolarization and Pericarditis with helpful simple tips to recognize them.

My fellow medics were all very excited afterwards, and anxious to go out and do 12-leads. The best EMS classes get you fired up about your job and Tim Phalen certainly accomplished that.

Kudos also to Mike Hooper, a name well know in this region, who has been the sales rep for Physio products since I can remember. Super nice guy. He taught us a class recently on how to use our new Life Pack 15s and accompanied Tim on his recent teaching tour of the area.

The latest edition of Tim’s book with updated material  will be coming out in November and will be available on Amazon.  You can pre-order it here:

The 12-Lead ECG in Acute Coronary Syndromes 4th Edition

1 Comment

  • I’ll second that. Tim is an amazing instructor, one I’ve had the pleasure of seeing first hand about a half dozen times. He stresses the fundamentals and builds from them, rather than flashy tricks and half-truths.

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