12 Lead EKG Adult
For Paramedics/ RN
Criteria:
Classic Chest Pain, Atypical Chest Pain,
Equivalents: Shortness of breath, , palpitations, syncope, General weakness/dizziness, DKA, hyperglycemia
Consider: Epigastric pain, upset stomach, n/v, diaphoretic patients, Altered LOC
Frequency: Initially with vital signs, where patient is found
In an Ambulance during transport, before leaving the scene or if an abnormality was found on initial 12 lead, during a hospital to hospital transport when pt has change on an EKG or symptom changes.
If an abnormality is found consider repeat every 5-15 minutes.
Follow chest pain protocols as indicated
Reminders:
Radio report (and fax if capable) on all suspected AMI's
Quick assessment and transport of all suspected AMI's.
Lead placement
V1
|
4th Intercostal Space @ right Sternum Edge
|
V2
|
4th Intercostal space @ Left Sternum Edge
|
V3
|
Between V2 & V4
|
V4
|
5th intercostal space, midclavicular line
|
V5
|
Level with V4, L anterior axillary line
|
V6
|
Level with V5, L mid axillary line
|
I
Lateral
|
aVR
|
V1
Septal
|
V4 Anterior
|
II
Inferior
|
AVL
Lateral
|
V2
Septal
|
V5
Lateral
|
III
Inferior
|
AVF
Inferior
|
V3
Anterior
|
V6
Lateral
|
Inferior MI: II, III, aVF
|
Septal MI: V1, V2
|
Anterior MI: V3, V4
|
Lateral MI: I, aVL, V5, V6
|