LP 12 .... ? 6 lead ?

[tskstorm]

I read this on another forum

You can always perform a "6-lead" from the LP-12 with just the arm and leg leads by hitting the 12 lead button. It says to attach the chest leads and hit 12-lead button again. Gives you I,II,III,aVr,aVL, and aVF. A whole lot of info that may help lead you as to whether a full 12-lead needs to be done. Of course if all of the obvious signs and symptoms are present then do the full 12-lead.

Anyone ever heard of this? or done it ?

I will be attempting it at work tonight just to see it ... (almost all of my patients get 12's anyway)

[FireMedic65]

If you are attaching leads anyway, why not just do the 12? Seems kind of pointless to do an EKG to see if you should do it the right way.

There are plenty of things you can do with equipment that it wasn't originally designed for. Personally, I think it is a waste of time to mess around with a 6 lead and moving leads around just to get 12.

There is a way of moving leads around on the old monitors where you only had 3 leads to move all the leads around to get a 12 lead reading. The only way I can see this being a benefit, is if you DON'T have a 12 lead monitor.

As for it being possible, yes, it is. It is a pain in the foot though.

[P_Instructor]

If you are attaching leads anyway, why not just do the 12? Seems kind of pointless to do an EKG to see if you should do it the right way.

I agree...what is the point, trying to save time or electrodes? If you are doing it to determine if the 12 lead needs to get done, then just do it anyhow.

[tskstorm]

From my understanding you attach the limb leads then hit the 12 lead button twice, no moving of leads ... The chest leads, v1-v6 wouldn't be visible but your augmented leads would ... Whether or not there is a benefit is another question.

ST elevation on a 3 lead is non-diagnostic from what I've been told, when you do a 12 lead it is diagnostic. So would this 6 lead be diagnostic? Would ST elevation in this 6 lead be diagnostic, would save you a few seconds and I do literally mean a few seconds before the chest leads for the 12 was put on ...

Edited November 9, 2009 by tskstorm

[WolfmanHarris]

Ya seems odd. If anything I do more 12 leads then some people I work with. The 12 or 15 lead is often my peace of mind to ensure I'm not seeing an atypical presentation MI. Especially with some of the populations I run into. (It's getting to the point that I'm willing to bet partners that a 40-50y/o M of Indian/Pakistani descent c/o abdo discomfort and general malaise is having an AMI.)

[spenac]

With the 4 limb leads you can see 6 views of the heart. Only way beneficial is if maybe you lost your 12 lead cable.

[tskstorm]

I hate to quote a number but I must say about or even at minimum 9 out of 10 of my patients get 12 leads, they make me lug that damn monitor to calls might as well use it ...

Please don't think I'm looking for a way to get out of doing 12 leads, just came across this and was curious about it.

[FireMedic65]

From my understanding you attach the limb leads then hit the 12 lead button twice, no moving of leads ... The chest leads, v1-v6 wouldn't be visible but your augmented leads would ... Whether or not there is a benefit is another question.

ST elevation on a 3 lead is non-diagnostic from what I've been told, when you do a 12 lead it is diagnostic. So would this 6 lead be diagnostic? Would ST elevation in this 6 lead be diagnostic, would save you a few seconds and I do literally mean a few seconds before the chest leads for the 12 was put on ...

Correct, if you look at a 12 lead and look at lead II, it might be NSR for example. If you look at say aVR or V2 or whatever.. you might see ST elevation. You won't see elevations in the lead II unless that is where the infarct may be.

I don't really see how you can not move leads around, and still get readings from V1-V6. You put the leads where they are for a reason of getting readings from that angle of the heart.

I do not believe doing this "trick" will be considered a good tool for a diagnostic reading. In essence, you are tricking the monitor I would think. The only way I could think this would be used for, is if your 12lead cables got damaged, or you want to show off to a group of students.

If it works, cool. I'd much rather have the proper 12lead done myself though because you just never know.

[tskstorm]

Correct, if you look at a 12 lead and look at lead II, it might be NSR for example. If you look at say aVR or V2 or whatever.. you might see ST elevation. You won't see elevations in the lead II unless that is where the infarct may be.

I don't really see how you can not move leads around, and still get readings from V1-V6. You put the leads where they are for a reason of getting readings from that angle of the heart.

I do not believe doing this "trick" will be considered a good tool for a diagnostic reading. In essence, you are tricking the monitor I would think. The only way I could think this would be used for, is if your 12lead cables got damaged, or you want to show off to a group of students.

If it works, cool. I'd much rather have the proper 12lead done myself though because you just never know.

I beleive the 6 lead would consist of 1,2,3 avf, avr, and avl you wouldn't get readings from v1-v6 ...

[mobey]

Actually I did this on almost every patient I attatched the monitor too until we got the chest leads ordered in.

ST elevation on a 3 lead is non-diagnostic from what I've been told, when you do a 12 lead it is diagnostic. So would this 6 lead be diagnostic? Would ST elevation in this 6 lead be diagnostic, would save you a few seconds and I do literally mean a few seconds before the chest leads for the 12 was put on .

Complicated answer but here it goes.

When you interpret rythm in lead II, the monitor filters out what it sees as artifact (some).

When you push the 12 lead button, the filters shut down and you get a clear picture in "Diagnostic mode".

So, in essence, yes the 6 lead would be diagnostic.

But: You do not have the "whole picture". so really.... it should not be relied on. To truly diagnose STEMI, all leads should be analysed. Pretty hard to see recprocal changes when your missing 2/3rds the 12 lead.

BUTT: In a situation such as a cable failure, you could move your LL (red) lead into the spot of V1 and print. This will now make lead II become MCL1. Now move it to the position of V2, it now becomes MCL2.... etc etc.

As long as you print each of these positions with the 12 lead button and not the standard "Print" button, you will, eventually have a diagnostic mode ECG from just the limb leads.

Not very practical I know, but that was not the question.

Change the rule to "ST elevation seen when the print button is pushed is non diagnostic"