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
Colleen
68 y.o. male with weakness: “Treat the monitor, not the patient?”
Allergies? O2, combivent, Calcium. Repeat 12lead ekg. 2nd set of signs. Depending on 2nd Ekg and 2nd set of signs with combivent, reassessment of patient after interventions. Depending on reassessment, 2nd/3rd VS, and 2nd EKG, would determine my decision on where to transport. Per Massachusetts protocols.
2014-10-02 05:57:52
Billy Bob
68 y.o. male with weakness: “Treat the monitor, not the patient?”
Well I will lean with Dave and go with more education; this is a classic sine wave EKG and with more education hopefully we all could spot this from across the door because again as Dave said this is something rarely seen in EMS if at all; this is the ONE TIME I will advocate…
2014-10-02 02:49:58
david
68 y.o. male with weakness: “Treat the monitor, not the patient?”
Looks like sine wave. QRS >.15 tall peaked T waves prolonged PRI, indicative of hyperkalemia. Calcium, bicarbonate, 50% dextrose perhaps even some albuterol, insulin at the Ed
2014-10-02 02:44:55
Hollywood Mike
68 y.o. male with weakness: “Treat the monitor, not the patient?”
ALS weakness and fall. Mental status is such that he remembers falling. I'm not going to get all excited about this tracing. I'm treating the guy for his complaint and watching him like a hawk during transport. I've seen some aberrant conduction that makes this ECG look like NSR so I'm jaded by experience (need…
2014-10-02 01:51:00
PandaMedic
68 y.o. male with weakness: “Treat the monitor, not the patient?”
It's great to see so many different points of view and styles, it's sad that so many of us are being critical and condescending towards other practitioners. Dave has a point, in that more education is needed, but there is something to be said for everyone who is here, reviewing these case studies and actively…
2014-10-02 01:45:45

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