15-lead transmission

[TheGodfather]

For those of you that perform 15-lead EKGs for suspected right/posterior MI (or possible extension of confirmed MI) how do you go about transmitting it to your receiving hospitals?

Is there a way to change the names of V4, V5, & V6 to V4R, V8, & V9 before transmitting? What I have been limited to is transmitting my initial 12-lead first, and putting in the patient name field, put this: "*patients name* - 1" ......then on my 2nd transmission (of the 15 lead), in the patient name field, put this: "*patients name* - 2"...THEN after that, make sure whoever is on the other end of the radio understands that "1" means normal 12-lead findings, and "2" means V4R, V8, and V9....

often times, i find this wastes valuable time that i could be giving patient care, and more likely than not, the hospital doesn't understand and assumes they are just repeat 12-leads


what are you all doing? any tips?

 

[STXmedic]

I just call the hospital and tell them the one they're getting is a R sided, and let them know which leads are changed

 

[medicsb]

Do they require that you send all 12 leads? If there's nothing noteworthy on the 15 lead, why send it? If there is STEMI on the standard and changes also on the 15, I'd transmit just one and call and notify the changes in the other leads. STEMI should equal cath lab no matter where it is seen.

 

[TheGodfather]

Do they require that you send all 12 leads? If there's nothing noteworthy on the 15 lead, why send it? If there is STEMI on the standard and changes also on the 15, I'd transmit just one and call and notify the changes in the other leads. STEMI should equal cath lab no matter where it is seen.

Unfortunately, per my local protocols, they do require transmission of all 12 leads (with attached patient name). Med control has us on a pretty tight leash where I'm at, probably due to a majority of the older medics treating people with passive "good ole' boy" ems intervention. -------not to mention, they gotta deal with a lot of young punks like me!

 

[Shishkabob]

If it's a non-standard 12/R/15 lead, call them and notify them of it.

 

[MSDeltaFlt]

To what's been said already. I don't know of any monitors that have a function where you can rename any leads at all; let alone prior to transmission. Inform them what you're sending and make sure you properly label them when you chart.

 

[jpmedic21]

we disconnect V1 to indicate right sided tracing or V4R

 

[Shishkabob]

we disconnect V1 to indicate right sided tracing or V4R

That has been taught to me as well, but I doubt many nurses, who are not trained to read a 4 lead let alone a 12 or 15 lead, will know this. Add on top of that, if doing a right sided 12, you'll still want V1.

 

[jpmedic21]

why do you still need V1? The heart isnt moving. V1 placement isnt moving. You see the same waveforms if you do right or left sided tracing.

 

[Shishkabob]

why do you still need V1? The heart isnt moving. V1 placement isnt moving. You see the same waveforms if you do right or left sided tracing.

That's the issue with doing a non-standard 12... there are so many variances on what is considered a right sided tracing.



Some say mirror left sided but on the right side (meaning V1 and V2 switch, too)

Some say just move V4 and get V4R.

Some say mirror right with left, but V1 and V2 stay put.

Some even say do V4R, but also have V7 and V8, or skip V7 and have V8 and V9.



This is why I just label each individual lead that I move ^_^