Tag Archives: axis determination

QRS AXIS DETERMINATION

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During ECG interpretation, cardiac Axis, or direction of electrical impulses, may be normal (physiologic) or abnormal (pathologic), suggesting abnormal cardiac conductivity. Although every deflection obtained on the ECG will have an axis, we will focus on the ventricular axis. When we think of our cardiac monitoring lead placement, we have to understand cardiac Vectors, which is the […]

90 year old female CC: Seizure – Conclusion

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This is the conclusion to 90 year old female CC: Seizure. Be sure to start there first! When we left off, we had completed our initial assessment of a 90 year old patient who, based on bystander accounts, had a seizure. She is pale, cold to the touch, and feels lethargic. During our assessment she […]

64 year old male CC: Indigestion – Discussion

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This is the discussion to 64 year old male CC: Indigestion. If you recall, we had a stubborn gentleman complaining of indigestion with a significant cardiac history. Considering the symptoms kept our patient awake, are highly suggestive of a coronary event, and we have uncompensated hypotension, we should have a keen interest on any ECG […]

Video: Axis Determination

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So you’ve read our blog, followed us on Facebook, submitted your own case studies, but you’re looking for more. You’re looking for the next big thing in EMS 12-Lead education. As a test run I’ve put together a video,shotKahn Academystyle using a pen and tablet, covering rapid axis determination. When I learned 12-Lead interpretation in […]

Why learn axis?

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A few weeks ago on JEMS Connect there was a thread called Vectors, Axis and Cardiology. In it, Dave M. asked: I truly enjoy learning and studying the heart, how it works and why it works that way. I had the privilege of teaching a paramedic class today and going over the vectors and axis […]

Axis Determination – Part VI

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By now you can predict the QRS axis in the frontal plane within 15 degrees as long as you have an equiphasic (or isoelectric) lead in the frontal plane. So what constitutes a normal QRS axis? What is a left axis deviation? A right axis deviation? If you don’t have a copy of the hexaxial […]

Axis Determination – Part V

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In Part IV, I promised that I’d show you a fascinating relationship between the standard 12 lead ECG and the hexaxial reference system. You will recall that to use the hexaxial reference system, you find the most equiphasic (or isoelectric) lead in the frontal plane (first 6 leads of the 12 lead ECG) and look […]

Axis Determination – Part IV

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By now you should have a fairly good grasp of how the hexaxial reference system is derived from the first 6 leads of the 12 lead ECG. Before we break down the finished diagram, let’s look at the hexaxial reference system laying on top of the patient’s anterior chest, with the arrows and leads in […]

Axis Determination – Part III

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In Part II, we discussed the heart’s mean electrical vector and how Einthoven’s Triangle (leads I, II, and III) can be redrawn to form the first 3 spokes of the hexaxial reference system. Essentially, we ended up with a shape like the one on the right. When leads I, II, and III are drawn this […]

Axis Determination – Part II

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In Part I, we looked at Einthoven’s Equilateral Triangle and Einthoven’s Law, and I told you that it was the key to understanding the formation of the hexaxial reference system. But before we delve further into the hexaxial reference system (the instrument we’ll be using to calculate the heart’s QRS axis) we need to address […]

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EMS 12-Lead

Cardiac Rhythm Analysis, 12-Lead ECG Interpretation, Resuscitation
Comments
Ethan Camden
Appropriate Cardiac Cath Lab Activation: Optimizing ECG interpretation and clinical decision making for acute STEMI
Hello - can you please send me the link to the full article published on Ivan Rokos, M.D., relating to Indications for Cath Lab activation (from 2010, AJH) ? Thanks! Ethan
2014-08-25 11:10:49
Conclusion to 80 Year Old Male: Fall | EMS 12 Lead
80 Year Old Male: Fall
[…] is the conclusion to 80 Year Old Male: Fall. If you do not remember the particulars, check out the original post and then come back here to […]
2014-08-25 09:34:45
Billy Bob
“Bad heartburn” – 82 y.o. female without chest pain.
Well shame on me I just read the conclusion (no RVI and it was indeed a LCX).
2014-08-25 02:06:49
Billy Bob
“Bad heartburn” – 82 y.o. female without chest pain.
I'm a bit late and curious to read the conclusion (coming after this) I agree with all and again to beat the dead horse but yes I agree with 12 leads in the setting of GI symptoms (specifically here) as it is quite common to have "heart burn" as the C/C for IWMI due to…
2014-08-25 02:01:05
Bryan Laviolette
“Bad heartburn” – 82 y.o. female without chest pain.
misread the BP, apologies
2014-08-24 21:18:42

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