BLS 12 leads

[mobey]

So what are your thoughts??

With Lifepak 12 becoming a "standard" monitor on most rigs should BLS services be obtaining 12 leads where indicated?

Not necessarily interpreting, just printing one off for the receiving hospital?

[Scaramedic]

I might end up getting flamed for this, but I don't think its that bad of idea. Especially if you are transmitting it to the ED prior to arrival.

[FireMedic65]

I agree, if they are trained on how to use the 12 lead... then let them do it. They aren't hard to put on, and not hard to press a button to analyze it....

But if you have the need to do a 12 lead, shouldn't ALS be there anyway? Before anyone says "what if they aren't available blah blah blah" ok I can see that... but in the long run, it would be a waste of money.... but that's just me

[mobey]

but in the long run, it would be a waste of money.... but that's just me

But the money is already spent. Most services are using a lifepak 12 for monitoring anyway (like the BLS service I work for). The equipment is there...just need the protocol!

[Mastabattas]

Are there stats out on what equipment services are using? I've been prostituting myself to a number of different services and keep seeing the Zoll...

As for 12 leads for BLS... interesting question. I know Nova Scotia PCPs do 12 leads but only have the diagnostic skills to determine if it's a right sided MI or not.

If the only real advantage is to send the strip to the hospital... because of the possibility of poor placement and even a poor read is it really worth it to take that extra bit of time. If the patient is potentially that serious I agree that ALS would be at the very least already called, and even if they're not available transport to the nearest facility would be our number one priority.

As much as I enjoy the idea of expanding scope I also think it's more important to remember our number one goal, which is to get the patient to the hospital for definitive care. Getting a 12-lead isn't going to change OUR treatment for the patient at this point. We can't interpret it... our skills for placement are often weak... the hospital can usually get a much better picture... and we can't do anything to fix whatever it might show.

[mobey]

Are there stats out on what equipment services are using? I've been prostituting myself to a number of different services and keep seeing the Zoll...

No stats I am just shooting from the hip.

The services I have been involved with are all using lifepak on first car and zoll or lifepak 10 on the other cars.

The Zoll M series is also 12 lead capable.

[VentMedic]

The only advantage would be to have a baseline EKG when the actual Chest Pain was occurring. Many times the pain and the EKG changes are transient and it is difficult to get good documentation until they are stress tested. I have spent countless hours in the hospital trying to catch an elusive arrythmia, especially for pacemaker qualification, or capture the moment of CP in print.

Other than that, ALS or BLS, all EKGs are usually repeated as soon the ER can get set up in most hospitals for serial comparisons.

[emt2emca]

As a PCP I am doing 12 lead acquisition and interpretation. As far as monitors are concerned I am a fan of Lifepac. starting next month we will be rolling out MRX's also with 12 lead. I believe that it is all about quick and early recongition of a STEMI and take the appropriate steps. I work in two services one has ALS and one does not. With that being said if you are given a tool you should be able to read it and not be only able to tell what you could already read on lead II. I think that it is our responsibility as the level of professionals we say and espire to be that we learn how to read the 12 lead for all types of MI's, not just a right. Our ED's have come to trust our intereptation and print outs to the extent that alot of ED doc's will give tx without repeating the test first. If we become proficient and confident in what we find everyone else in the chain will follow suit. After all isn't it about getting the door to needle time down.

Sorry if I'm just rambling and not making sense... been a long shift.

[Acosell]

I know of at least one BLS only service that has 12 leads, and uses them for their STEMI protocol. They'll bypass the nearest hospital and go directly to the Cath lab. (or something to that effect). As for more urban centers, I would say that the benefit of BLS 12 leads is questionable depending on how it is implemented.

[akroeze]

I know of at least one BLS only service that has 12 leads, and uses them for their STEMI protocol. They'll bypass the nearest hospital and go directly to the Cath lab. (or something to that effect). As for more urban centers, I would say that the benefit of BLS 12 leads is questionable depending on how it is implemented.

Not sure if it's who you are referring to but Simcoe (Barrie) does this.