Right sided EKG/Nitro

[NPO]

As relation to this topic and 12-leads. Do you do a posterior EKG if you get ST depression in the v1-v6 leads right? Nitro indicated?

And what is the significance of frequency response? How about axis deviation? We touched up on those subjects but didnt go too much into detail. Will read about it when i get a chance

Do I? Generally, as long as it's suspicious for ACS.

Posterior MI has the highest rate of failing to identify, as high as 50% by paramedics according to some studies.

It's quick and easy. Does it change my treatment? Not likely. But it might activate the Cath Lab if it's a true STEMI.

 

[VentMonkey]

Do I? Generally, as long as it's suspicious for ACS.

Posterior MI has the highest rate of failing to identify, as high as 50% by paramedics according to some studies.

It's quick and easy. Does it change my treatment? Not likely. But it might activate the Cath Lab if it's a true STEMI.

Yes, but clinical judgement, and signs/ symptoms accompanied with depression in the apical leads should be enough to tip off any prudent clinician.

We can't base everything on studies and numbers alone, some things should come with knowledge and gut instinct, which in turn allows the ED to trust your judgement, and all of ours, that much more.

I guarantee there will be times when you won't even think to do a posterior 12 lead, let alone have time (they can crump rather quickly), so there's something to be said about a strong clinical base to begin with, which I don't doubt you possess.