BLS 12 leads

[Acosell]

Yes, Simcoe County Paramedic Services was the service I was referring to.

[dean83]

PCP's with protocols for ASA/NTG are a standard in Alberta. To properly rule out a RVI a 12 lead is helpful as a monitoring device.

[GPEMS2121]

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?

I live and work in Minnesota, We run Zole monitors and our basics do 12 leads and interpret them as well. It is a wonderful thing to know for the basics.

[andymascall]

We routinely have BLS doing 12 leads here, and interpreting if they feel able - it also gives them guidance as to whether they call for paramedic backup or not - we thrombolyse pre hospital also.

So I think a positive YES - where indicated - any grade should be doing 12 leads

Andy

[croaker260]

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?

1- Just because its a lifepack 12, doent mean its a 12 leads...12 lead became integral with the LP 11, but I remember seeing an extra device before that for the LP 5 and 10. The LP 12 it is an extra feature, (read $$ option)

2- That said, we train out basics to do them here. Since we run an all ALS service it only is an assistance to the medics. But we have the ground work for future BLS only rigs.

[Dustdevil]

And the winner is...

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.

In other words, in all but the rarest circumstances, it's a horrible idea. Do you know how many AEDs or sets of body armour you could buy with the cost of just one Lifepak 12 that provides you no benefits for your patients? You could hire another full-time medic for a year with that money. NO justification for that. Any manager that even considers this nonsense needs to be sacked.

[JPINFV]

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.

Strange, that's not stopping LA or Orange County, CA from having their medics get a 12 lead for the machine evaluation.

/agree that 12 lead for BLS is just useless though

[katbemeEMT-B]

So I'm not really sure how I feel about this. Part of me says no way, it would be stupid. The other, more rural, lack of definitive care, part of me says, hell yes.

This is how I see it. If the service is not going to take the time to educate their members on how to properly place, read, and interpret the ECG, then they don't even need the LP onboard. Any simple bp machine would do. I mean, why spend the extra money for all those bells and whistles when you will never utilize them. And again, will it change how you treat and transport your patient if you print out a strip and have no idea what it says. That would be a big fat NO.

On the other hand, being in a rural area, with a VERY rural hospital, I could see where being educated on EKGs and having the ability to perform a 12 lead would benefit our patients. If the ECG were positive for any kind of disturbance (let's say an MI), we would be able to alert the ED who in turn would activate Life Flight. This would save about ten to twenty minutes of time, getting the patient to the true definitive care that is needed. Our local hospital doesn't have the capabilities to deal with heart issues unless the cardiologist happens to be there which is only four times a month. The hospital's protocol is when a chest pain comes in, they do a work up, and then if it is determined the patient is indeed having a heart issue, they transfer them to a Metro hospital where they receive a more specialized care. Depending on the issue, transport is either by ground ALS or Life Flight (usually Life Flight). The nearest ground ALS is thirty miles away from the hospitial.

But yet again, I can also see, being in wankerville like I am, a skill like this being over utilized and the wankers not following through with the training required to adequately perform an ECG.

So you see, I am really on the fence with this one. I think deep down I know it just wouldn't work. On the surface, I want it to. My experience on the ALS service has given me the opportunity to perform EKGs and the medics encourage me to interpret them. They then take the time to explain what they see, how they determined it, and why it appears as it does. It truly is a wonderful learning experience.

[threebl9mice]

my personal experience....why not ? It requires an in-service to get up to speed....then go for it... I have had bosses who didn't trust electronics....insisted on all vitals being done by manual not by life pack...The boss hated these new fangled boxes why he could remember a time.....I laughed and said yes sir yes sir 3 bags full....

This is new and valid technology. medics use to have to transmit to the doctor the ecg and then wait for the ok to shock....now a novice w/ no medical training is shocking....I only see our scope expanding as the technology increases. For those of you out there in medic land who want manual all the time...Pttbbhhttt! Technology is here to stay... keep up or get out! Its all about the safety and care of Pt.s right??

[JPINFV]

This is new and valid technology. medics use to have to transmit to the doctor the ecg and then wait for the ok to shock....now a novice w/ no medical training is shocking....

Um, exactly when were medics required to get a 12 lead before defibrillating and/or where are novices with no medical training allowed to electrocardiovert? I honestly think that comparing 12 leads to manual defibrillations to using an AED is a non-sequitur.

I only see our scope expanding as the technology increases. For those of you out there in medic land who want manual all the time...Pttbbhhttt! Technology is here to stay... keep up or get out! Its all about the safety and care of Pt.s right??

You're right, technology is here to stay and it is about patient safety and care. So tell me, what part of an EMT-Basic's education prepares them to interpret or even make use of the information provided by a 12 lead ECG?