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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Proficiency vs Deficiency… The Art Of Electrocardiography | EMS 12 Lead
Understanding Amiodarone
[…] on the highlighted title for an Amiodarone breakdown, UNDERSTANDING AMIODARONE   One tool I use in these cases of bradycardia, is SPo2 monitoring. Remember, with every systole […]
2015-05-22 16:59:43
Wayne
12 Lead ECG – Lead Placement Diagrams
I have been doing EKG's for the past thirty years. It use to be that you always lay the patient in the supine position but here lately I have been told that with the patient sitting up right will not change the EKG, is this so ?
2015-05-21 17:37:37
Ivan Rios
Understanding Atropine
Hi Tony, thank you for writing. It's always a bit of a gamble to give opinion in such topics without being there, however, addressing ventilation is a must. The rate could be secondary to vagal stimulation and/or respiratory depression, but it sounds like the patient is compensating pretty well when it comes to the hemodynamic…
2015-05-21 12:55:43
Tony Correia
Understanding Atropine
Looking for an opinion. Had a pt. who was unconscious from unknown etiology, Agonal respiration = 6, SPO2 = 59, heart rate =37 sinus bradycardia, B/P = 137/80 . We ventilate the pt. approx for 2 minutes without change in status. Would you have administered atropine or continue with BVM to attempt to correct hypoxia,…
2015-05-21 12:16:26
dan
57 year old male: Chest Discomfort
I'm sorry but I don't see any flutter here. With a rate of 150 we are at the very upper limit of sinus tach. No O2 is indicated with a pulse ox of 94%, especially if you are thinking cardiac. Place in position of comfort, large bore IV, fluid bolus, ASA, nitro, capnography, complete assessment…
2015-05-14 03:50:36

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