12 Lead EKG?

MMiz

MMiz

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The company I work for has an EMS contract with a city. Several companies bid, but we were the only ones that did 12 leads. I'm wondering how common it is. I know when I did my ride-along with AMR they did a 3-lead.

It seems to be one of those things that is slowly catching on. Our crews required a bit of extra training to do it, but it seems to really set us apart.
 
All the ALS services around here have had 12-lead capablity for some time. They're is a new program underway at one local hospital to have the paramedic's diagnose an MI in the field via set screening criteria and upon consultation with medical command, these patients will be transported direct to the cath lab versus to the ED.

I think 12-leads are great in the field.
 
My ambulance corps uses 3 leads for the Critical Care EMTs and the Medics and the 80 car (first responder) have the 12 lead upgrade for the same machines. We use the Lifepack 12's and I like them (the FD has a Zoll and it's ok too, they're just very different).
 
Many Basics in my area are trained to do 12 lead. I think its great considering the long transport times, and that ALS rarely makes it on scene before we take off. We can have already have the pt hooked up when we intercept with the medics, I think they appriciate it.

EDIT: oops that was a little incoherent....
 
Are they trained to interpret and treat as well, or just to set up the machine for when ALS arrives?

I had a "Tylenol OD" on Saturday - a 19 yo who took an entire valu-size bottle of Tylenol. He was playing possum to a certain extent, but I think he took his albuterol too - he was tachy at 120 but would drop by steady increments to 90, then shoot straight back to 120. He missed 4 or 5 beats at one point and scared the petooties out of me because I was alone in the back, with a new driver up front. :rolleyes:

Oh, and I wasn't running ALS (haven't been "cleared" to operate on my own at the ambulance corps yet) - so all I had was a pulse ox to "monitor" his heart.

When we got to the hospital and were finally able to get an ECG, he was in sinus tach. He started to "come around" when they threatened him with an NG tube. :o
 
We are trained to recognize some basic rhythms, and have no interventions above BLS protocols. It’s mostly to give the receiving hospital or intercepting medics a heads up. And yes, they do like it when they climb onboard and the pt's wired and ready. ;)
 
I'd be happy if they would let us interpret 3-leads.

Our current interpretation of ECG strips is "Good" or "Bad". :angry:
 
"If you don't know the rhythm, shock it till you do!"
 
Originally posted by rescuelt@Jul 7 2004, 08:30 PM
"If you don't know the rhythm, shock it till you do!"
Click to expand...
:lol:

Unfortunately, we're not even allowed to interpret the 4 basic rythyms (sinus, V-Fib, Asystole, and PEA). :angry:
 
A project that is currently in the works in my jurisdiction, is the ability to send digitally the lifepac ECG reading to the recieving hospitol. Even as a basic, the recieving facility will have a much better understanding of patient condition and allow medical direction the ability to tell the basics on the med some intervention that they may be capable of making but are not sure if it required. And, as stated before, having a patient hooked up to a 12 lead ECG has many added benifits.
 
In order for a vehicle to be ALS certified in NY State it must have a monitor/defib (such as the Lifepack12) WITH telemetry capabilities, and the appropriate cell phone over which to transmit the telemetry to medical control (at the State Hospital).
 
We all do 12 leads as medics, and all of our EMT's are taught to set up the 12 lead and apply it to free up hands. WHile soem are better at reading thena others, we have several "12 lead gurus's" in our dsepartment that help do the referesher training.
 
I was just told on Tuesday that the Corps wants me to attend a 12-Lead class. Technically as a CC it's not required (3 is good enough) but what the heck, the more the better... plus I get CME credit for it.
 
12 leads are essential to my medical director's protocols. We use LP12 with telemetry, ETCO2, SPO2 and NIBP. Jeez, I love my lifepack 12!
:wub:
 
Fire Chic I also love the Life Pack 12 well until you have to carry the darn thing to the 14 floor on an 90 degree August day when the elevator stops working...lol


We are a tiered agency and we have a paid ALS crew on from 6am -6pm and 6pm -6am we are a volunteer agency. We allow EMT-B to be crew chiefs and drivers in the agency and with 1 crew chief and a driver a ambulance may leave the station. If this is the case the ALS gear is locked in a cabinet and we are also one of the few agencies in NY to carry Narcotics so we do have to meet additional guidelines for controlled substances. We also lock the the manual defibrillators in the cabinet as well. We do use a LP 5 which has the key to change from AED to manual for the basics - the benfit to that is the LP 5 and LP 12 and newer accept the same lead systems so once a patient is monitored on a LP5 they can be easily swicthed to a LP12 system once a ALS provider is available in the case of an intercept or a ALS member responds to the scene in their private vehicle.

We do train the BLS members in the setup of the 12 lead system from point of view of assistance in how they should interact with the ALS provider and the patient while a 12 lead is being hooked up and used. I am one of those old times that remembers before EMT-Bs being allowed to defibrillate at all, and I do see one day BLS providers gaining more skills comming down from the ALS providers and maybe one day that will be 12 lead EKGs.


Julie
 
Originally posted by medicfire909@Aug 4 2004, 12:22 AM
We do use a LP 5 which has the key to change from AED to manual for the basics
Click to expand...
The LP12 can also be used as an AED as well.

Erika, You said you use a 12, can you monitor A-Lines as a CC/Paramedic or is a Nurse still needed for that?

I have used the LP12CC. It is a very fun toy.
4 or 12 Lead monitoring, SpO2, ETCO2, NIBP, and A-Line Monitoring
 
Originally posted by PArescueEMT@Dec 28 2004, 11:00 PM
Erika, You said you use a 12, can you monitor A-Lines as a CC/Paramedic or is a Nurse still needed for that?
Click to expand...
We're allowed to, if we're trained for it. The Corps is going to do an inservice in the next couple months for those of us not already specifically trained (myself included).
 
Originally posted by PArescueEMT+Dec 28 2004, 11:00 PM--></div><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>QUOTE (PArescueEMT @ Dec 28 2004, 11:00 PM)</td></tr><tr><td id='QUOTE'> <!--QuoteBegin-medicfire909@Aug 4 2004, 12:22 AM
We do use a LP 5 which has the key to change from AED to manual for the basics
Click to expand...
The LP12 can also be used as an AED as well.

Erika, You said you use a 12, can you monitor A-Lines as a CC/Paramedic or is a Nurse still needed for that?

I have used the LP12CC. It is a very fun toy.
4 or 12 Lead monitoring, SpO2, ETCO2, NIBP, and A-Line Monitoring [/b][/quote]
PArescueEMT, this is our continuing argument. I like the Zoll's myself for Critical Care / working a code in hospital, but the 12 is truly an EMS monitor, and, espicially with the 2 batteries vs. 1 is a much better field monitor, but both can do everything but actually wash the dishes :lol: :D :rolleyes: :lol:

RescueCpt

So CC is better than P???



Oh, and one squad out my way is using the new phillips, as it can be locked with a keycode to be BLS-only AED, or unlocked and do 12 leads (i think)

12 leads are a valuable diagnostic tool, but A you need to know how to read them, and B you need to pass them on to the doc to read.


Jon
 
No, CC and P are the same except for 3 things:

1. P's get paid more
2. P's are in school longer
3. P's can do a needle crych (sp?) CC's cant... YET.

Otherwise everything is the same, P's have a few more standing orders but in the end we have the same skills and the same overall orders.
 
We run with the LP 12's. Usually hook up 4 leads. As an EMT I can hook the patient up if I have requested ALS and they are not 20 minutes out!! :lol:
 
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