Tag Archives: lead placement

Comparing 12-Leads: Discussion

Entry Img

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

Entry Img

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

Entry Img

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"

Entry Img

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

Entry Img

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

Entry Img

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

Entry Img

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

Entry Img

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
Comments
Brooks Walsh MD
“Bad heartburn” – 82 y.o. female without chest pain.
The option was indeed turned on! As for non-CP presentations of ACS, I absolutely believe that these warrant the same level of urgency as the "typical" presentations. Both men and women, young and old, all commonly present without classic chest pain. Besides, how much difference is there between "burning in the epigastrium," and "pain in…
2014-08-21 17:10:37
Austin
“Bad heartburn” – 82 y.o. female without chest pain.
You took the words right off of my keyboard, Jason! A little bit of critical thinking works wonders when faced with "protocol versus best interests of the patient" type decisions. Not to encourage deviation from protocols and such, but it is a much less severe trespass if you bend the rules a bit as long…
2014-08-21 16:33:27
Brooks Walsh MD
“Bad heartburn” – 82 y.o. female without chest pain.
My uninformed opinion? I pretty much agree with AHA - if they aren't hypoxic, no need. I'm not sure how terrible superoxia really is, short-term, but why bother if it doesn't help?
2014-08-21 16:31:05
jason
“Bad heartburn” – 82 y.o. female without chest pain.
Chris Watford- as you probably know the "acute MI suspected" detection function in the LP12/15 is a programable option. I suspect the software didn't miss this but rather it wasn't turned on. As for treatment everyone has pretty much got it down. Finally as for activation. Absolutely! Don't real care if the protocol allows for…
2014-08-21 16:30:34
Austin
“Bad heartburn” – 82 y.o. female without chest pain.
There's not much I think I can add at this point, but I will comment on a couple of things. The reciprocal changes indicate to me that there is likely RCA involvement. Also, I've recently been hearing quite a bit about withholding O2 in ACS patients like this. Dr. Walsh, do you have any opinions…
2014-08-21 16:23:21

STEMI Expert?

  • Click here to find out!
  • 12-Lead ECG Challenge Smartphone App

    Photobucket

    12-Lead ECG Challenge Smartphone App - $5.99

  • Apple iOS
  • Android
  • Amazon
  • Web Based

  • FRN-TV video review
  • iMedicalApps.com review
  • Interested in resuscitation?

    FireEMS Blogs eNewsletter

    Sign-up to receive our free monthly eNewsletter

    Visitor Map / Stats

    Locations of visitors to this page


    LATEST EMS NEWS

    HOT FORUM DISCUSSIONS