Procedure 18 — Cardiac: 12 Lead ECG & Cath Lab STEMI Activation

Name three clinical indications for obtaining a 12-lead ECG.

Suspected cardiac patient, suspected medication overdose, or electrical injuries.

Name two more clinical indications for obtaining a 12-lead ECG.

Syncope and acute altered mental status.

What general condition also indicates a 12-lead ECG?

Any condition where a 12-lead ECG may help determine patient status or guide treatment needs.

What is the first step in obtaining a 12-lead ECG?

Assess the patient and monitor cardiac status.

What should be administered as the patient's condition warrants during 12-lead ECG acquisition?

Oxygen.

What is the priority if a cardiac patient is unstable before obtaining a 12-lead ECG?

Definitive treatment.

When is a 12-lead ECG performed relative to patient stability?

If the patient is stable, or stabilized after treatment.

What must be done to the ECG monitor before acquiring a 12-lead?

Prepare the monitor and connect the patient cable to the electrodes.

What patient information must be entered into the cardiac monitor before a 12-lead ECG?

The patient's initials, age, and gender.

What should be respected while exposing and prepping the chest for a 12-lead ECG?

The patient's modesty.

What procedure governs how chest and extremity leads are applied for a 12-lead ECG?

The Assessment: ECG and 12-Lead Placement procedure.

What should the patient be instructed to do while acquiring a 12-lead ECG?

Remain still.

What is done after applying leads and instructing the patient to remain still?

Press the appropriate button to acquire the 12-lead ECG.

When should 12-lead ECG data be transmitted to the receiving hospital?

For all STEMIs or lethal arrhythmias.

What information should be communicated to the receiving hospital after sending a 12-lead ECG?

That a 12-lead ECG has been sent, along with the patient's initials.

What should continue after obtaining and transmitting a 12-lead ECG?

Monitor the patient while continuing with the treatment protocol.

What must be attached to the electronic PCR after obtaining a 12-lead ECG?

The downloaded 12-lead data, per guidelines.

What must be documented in the comments section of the 12-lead intervention?

The procedure, time, results, and the paramedic's interpretation of the ECG.

When should the ED be notified early regarding a 12-lead ECG?

If there is a suspected or confirmed AMI.

What should accompany early ED notification of a suspected or confirmed AMI?

An early transmission of the 12-lead ECG.

What provider levels can perform this 12-lead ECG and STEMI activation procedure?

EMT-A, EMT-B, and EMT-P.