Tag Archives: lead placement

Comparing 12-Leads: Discussion

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This is the discussion for Comparing 12-Leads: Common Error or Common Disease? All of our readers were on the right track, and many were spot on! Sometimes, troubleshooting an ECG is more than just lead placement. In this case report, we had three 12-Lead ECG's, all featuring a similar pattern: inappropriate R-wave progression. Initially, when […]

23 year old male CC: Chest Pain

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Here’s a fascinating case submitted by Geoff Dayne. EMS is called to a VA clinic for a 23 year old male who came in to get checked into the system. Somewhere in the exchange, he mentioned that he had been experiencing chest pain off & on for just over a month. Onset: Today’s pain came […]

72 year old male CC: "Unknown problem" – Conclusion

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Here is the conclusion to 72 year old male CC: Unknown problem (man down) Here was the initial 12-lead ECG.   Based on this ECG the lead paramedic called a "STEMI Alert" and transmitted the ECG to the receiving hospital. The on-duty ED physician received the ECG and the paramedic's radio report. The ED physician […]

72 year old male CC: "Unknown problem"

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EMS is dispatched to a 72 year old male patient. Third party call. History of Parkinson's Disease. Patient is conscious. No further information. On arrival, EMS finds a 72 year old Spanish-speaking male. Through an interpreter the lead paramedic determines that the patient became dizzy, fell down, and hit his head. A small hematoma is […]

Data quality, lead placement, your patient's dignity, and undressing female patients

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I thought long and hard about allowing anonymous comments on the PH12ECG blog. In my experience, anonymous posters don’t exercise the same level of responsibility as posters who use their real names or blogger identities. Anonymous posters are often bomb throwers. Or, they engage in proselytizing, propagandizing, sensationalizing, or advertising. For them, there are no […]

Contiguous and reciprocal lead charts

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Here are some charts to help you identify and localize acute STEMI on the 12 lead ECG. Contiguous leads What do we mean when we say leads are “contiguous”? Contiguous leads are “next” to one another anatomically speaking. They view the same general area of the heart (specifically the left ventricle). For example, these states […]

12 Lead ECG – Lead Placement Diagrams

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On October 15, 2008, Lynne left me this comment: I’m an EMT-B that just found your blog. My agency allows EMT-Bs to perform 12-leads prehospital, so that doctors and paramedics at the hospital have a printout to look at. Also, if our monitor sees an Acute MI or something critical going on with the heart, […]

Muscle Tremors, Your Patient's Dignity, and Staying Organized

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The importance of good data quality to a successful prehospital 12 lead ECG program cannot be overemphasized. After all, life and death decisions are made based on the 12 lead ECG. If an EMS system routinely transmits garbage to the emergency department, it should come as no surprise to anyone that the cath lab isn’t […]

EMS 12-Lead

Cardiac Rhythm Analysis, 12-Lead ECG Interpretation, Resuscitation

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Comments
know it all parapup
83 Year Old Male: Shortness of Breath
@ Kyle I would question your authority to call out people for not having a license or being a know it all parapup when your tx basically entails "call medical control." I think we can both agree that his cardiac output is not great at all. I assume your reluctance to give him any other…
2014-10-30 20:26:11
Kyle
83 Year Old Male: Shortness of Breath
Well st elevation in avr and v1 associated with anterior and lateral depression would call for possible posterior wall MI. 15 lead would be in order. Also check all the leads for appropriate placing. If v7, v8, and v9 show the elevation i would treat as a STEMI per my protocol. Asprin only until medical…
2014-10-30 18:14:05
Tim
The most awesome STEMI test on the internet!
Thanks for the app. It made me think about all that one may see in the field. The only problem was I never got a score or saw the results of how I did other than saying I had completed the test. Anyway a great way to get the old brain working.
2014-10-30 13:14:27
Brian
83 Year Old Male: Shortness of Breath
I mostly agree with dustin. I believe this is may be an isolated posterior MI. The R wave in V2 points to it being a posterior MI. otherwise it is a 1st degree av block with a LAHB. I am somewhat concerned with the concordant t segment depression noted and in fact if you were…
2014-10-30 04:22:44
Karl Brennan
Understanding Amiodarone
Great article , however in VF caused by hyperkalemia it should be avoided along with lidocaine , Since it shuts down the K channels, the eiteiology of the arrest hyper K, K channels are needed to exchange K in the cell. Calcium , Bicarbonate, dextrose and insulin should be used to decrease K levels along…
2014-10-30 03:04:45

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