Tag Archives: modified chest leads

Modified Chest Leads (was: Modified Leads "On the Ice")

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Occasionally I receive emails from readers who ask various questions or submit interesting ECGs which I sometimes use as case studies on the Prehospital 12-Lead ECG blog. Back in November I received an email from a reader who wrote: Hello! I’m currently in Antarctica on a medical support contract. I was issued a 3-lead Lifepak […]

50 year old male CC: Respiratory distress, chest pain

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EMS is dispatched to a 50 year old male in respiratory distress. En route, dispatch advises that the chief complaint is actually chest pain. On arrival, the patient is found lying supine on the floor just inside the front door to his house. He is cold to the touch and pale but his skin is […]

62 year old male CC: chest discomfort

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EMS is dispatched to a 62 year old male with a chief complaint of chest discomfort. On arrival, the patient is found sitting at the dinner table. He appears acutely ill. Onset: Fairly sudden after sitting down for dinner 20-30 minutes ago Provoke: Nothing makes the pain feel better or worse Quality: Dull pressure/ache Radiation: […]

Right ventricular infarction – Part III

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Let’s take a look at another case. This was one of the first ECGs ever transmitted to my local receiving hospital on the Lifenet Receiving Station. It was definitely the first STEMI. The data quality of the first 12 lead ECG wasn’t the greatest. This is the second ECG, with lead V4 in the position […]

Right ventricular infarction – Part II

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Let’s look at a case study that demonstrates the potential danger associated with right ventricular infarction. EMS is called to the residence of a 68 year old female with chest pain. On arrival, the patient is anxious, cool, pale, and diaphoretic. Vital signs are assessed. Resp: 20 Pulse: 68 BP: 105/55 SpO2 95 on RA […]

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, […]

EMS 12-Lead

Cardiac Rhythm Analysis, 12-Lead ECG Interpretation, Resuscitation

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Comments
Anne
Adenosine for sinus tachycardia: Try to avoid this!
If it were me, I would seek a second opinion; consult an electrophysiologist. Unlikely that you had sinus tachycardia at that rate.
2015-01-26 09:46:57
John
Adenosine given for a narrow-complex tachycardia over 150
If things such as Sepsis, Drug Use, Medication issues, Anxiety, Pain, etc.. have been ruled out, and the rate is still >160 (or whatever number you use). How else do you determine S-Tach Vs. SVT? Does a 12 Lead Help (QRS Complexes facing different directions due to different pathways etc..) or a simple 4 Lead?…
2015-01-19 19:44:32
Brandon O
Adenosine for sinus tachycardia: Try to avoid this!
She may not have had anxiety, but I bet she was a carrier...
2015-01-18 02:31:08
Brooks Walsh MD
Adenosine for sinus tachycardia: Try to avoid this!
Highly unusual for this to be sinus at that rate!
2015-01-17 19:21:04
Mel
Adenosine for sinus tachycardia: Try to avoid this!
I experience bouts of tachycardia. I had it investigated about 5 years ago after being woken during the night by projectile vomiting and feeling my heart racing/thumping with carotid pulse that I could certainly palpate but had no chance of counting (whether the 2 symptoms were related or coincidental, I don't know). I've had multiple…
2015-01-17 18:47:19

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