12 leads on females

[HERBIE1]

Dumb question: Does it matter if the breasts are fake or not? Is there a jiggle factor?

Not dumb at all. I found that with augmentation, the breasts are more dense and rigid which makes moving them out of the way more difficult. In these patients, the women aren't generally as self conscious(they're usually proud of their assets), and they are more than happy to help move them out of the way, especially if they are large.

[VentMedic]

I've seen numerous hospital EKG techs do that. That claim as long as it is over the correct landmarks it does not change the EKG. I would think extra tissue would intefer with the quality but what do I know I am just an under educated Paramedic.

The only time I have done that is on very obese women where the breast tissue is stretched thin at the 5th rib and the breast itself is displaced to even lifting it out of the way would still put the electrodes near the 9th rib or lower. I just make a notation about what I did in the computer and on the print out.

But, bariatric patients present many problems such as few hospitals have CT Scanners or MRIs to accomondate these patients. Thus, if you take an obese patient suspected of having a CVA they may not be able to do a CT Scan, even at a Stroke Center, and the patient may have to be CCT'd to another facility for the scan and then back to the Stroke Center.

Not dumb at all. I found that with augmentation, the breasts are more dense and rigid which makes moving them out of the way more difficult. In these patients, the women aren't generally as self conscious(they're usually proud of their assets), and they are more than happy to help move them out of the way, especially if they are large.

The saline implants rarely pose a problem.

Not all women have implants just for cosmetic reasons. Some have been breast cancer survivors or even did a prophylactic removal of the tissue due to cancer risk. There are also other types of surgeries and injuries where the woman has had to undergo reconstructive surgery.

So don't assume it is just a boob job for vanity to get male Firemen or Chiefs (spenac's article) to grope their breasts.

I have a little more to add.

If a woman has had a double mastectomy, do not treat her "like a man" and expose the chest to the world or annouce "its okay because she doesn't have any breasts". Use the same standards of privacy as if she still had breasts. If the surgery is recent or even if it is not, be gentle with the sensitive tissue. Also, if there are still sutures, don't pull the skin and electrode away from the incision stressing the suture and causing pain. Carefully pull toward the incision. This also applies for men as well. Also the same for both men and women who have had breast reduction surgery.

Edited January 19, 2010 by VentMedic

[AnthonyM83]

I keep hearing mention of using a towel or sheet to cover the patient while you do it. I've very rarely done this, not because I didn't care about maintaining privacy, rather it usually isn't necessary in order to keep patient covered. Do people remove the patients entire top or do you work around it?

V1 and V2 are usually fine. Then V3-V6 can be easily accessed from most tops, by either lifting and/or unbuttoning. Except for split second flashes while you move the shirt around, the actual breast usually is never exposed and it's done in the ambulance with doors closed, anyway.

Are we talking about draping the towel over her chest or holding it up in front of her? I feel the towel would fall off and make it harder to maneuver your hands, slowing down the whole process when breasts wouldn't be exposed in the first place. The exceptions would be when the patient is wearing a tight 1-piece, like a dress where it needs to be rolled up from knees to the chest area, then we use a sheet.

But then again, this is LA, for all I know I've been doing 12-leads wrong all this time. Wouldn't be surprised.

[JakeEMTP]

Anthony, are you saying you don't usually do a 12 Lead ECG in the person's residence before placing them in your ambulance? If we are dispatched to a CP call, we have made it a practice to bring in the ALS bag, O2 and the monitor. I would expect in L.A. there are always ample FF's to carry your equipment out.

[AnthonyM83]

Anthony, are you saying you don't usually do a 12 Lead ECG in the person's residence before placing them in your ambulance? If we are dispatched to a CP call, we have made it a practice to bring in the ALS bag, O2 and the monitor. I would expect in L.A. there are always ample FF's to carry your equipment out.

I guess it's half and half (I'm still working as an EMT, so it's never up to me), but if it's done inside the house, it's usually in a smaller room with no other family around and the rest of the firefighters step away unless critical (same privacy effect as if in a closed ambulance). Either way, there's minimal cleavage showing and IF there is some momentary exposure mid-hand movement, it's in a pretty private contained environment.

[JakeEMTP]

I guess it's half and half (I'm still working as an EMT, so it's never up to me), but if it's done inside the house, it's usually in a smaller room with no other family around and the rest of the firefighters step away unless critical (same privacy effect as if in a closed ambulance). Either way, there's minimal cleavage showing and IF there is some momentary exposure mid-hand movement, it's in a pretty private contained environment.

Gotcha. Yeah, as long as you(generic you)are in control of the scene and the additional help who have arrived is kept at a distance, I am in agreement.

[bullet498]

Thank you to everyone who took the time to reply. My question more directed to landmarks and placement not so much of keeping the pt's privacy, and as many of you said keeping a professional manner should go without question

[Richard B the EMT]

I was going to wisecrack on Pamela Anderson in the bleacher seats at Yankee Stadium, but decided against it.

[armymedic571]

I was going to wisecrack on Pamela Anderson in the bleacher seats at Yankee Stadium, but decided against it.

LMFAO........hahahahahahaha.

[Richard B the EMT]

So I'm a new EMT-I and was looking for advice for applying 12 leads on female pt's especially those that are of larger size

thanks

It just dawned on me: Why are your 12 leads of a larger size?

lol. Playing with you.