12 leads on females

[armymedic571]

Avoid "palming" the breast. Try to only contact with the back of your hand and use clothes, towel or sheet to move the breast or have the patient move it.

This is an excellent point. If anyone watched the video, you will notice that the provider on the video did just that.

As Vent has already stated. The key word is "Professional". Something that seems to be lacking........

Good Topic.. Hope everyone has a good day.

J

[Dustdevil]

But what if she asks you to palm it?

Oh wait... nevermind.

[fireflymedic]

If the woman is in a sports bra (and very large busted women may wear two to prevent excess movement if they are very active) you may have to remove the bra(s). However Vent makes an excellent point about preserving dignity - a sheet, towel, or most ambulances carry a gown or two draped over to maintain a bit of modesty goes a long way. I would also do this in the back of the truck where interaction with others is minimal at privacy is at a higher level or within their home and politely ask those that aren't needed at the moment to step out. There have been several times I've seen a patient brought to me with no covering of a blanket, sheet, gown anything. One of the first things I do is take care of some modesty, then assess removing only what I need to. It's bad enough you're in this situation and trauma naked I don't think I need to make it any worse. Especially depending upon the population you are dealing with - some are considerably more modest than others. There is a fairly large pentecostal population here as well as a good amount of amish (in addition mennonites) and both are extremely conservative about ladies showing themselves to others so something to take into consideration when treating a patient. They are more likely to be compliant if they know you are concerned with treating ALL of them with dignity and respect. That's professionalism people.

[VentMedic]

This is an excellent point. If anyone watched the video, you will notice that the provider on the video did just that.

Wow! That was a bad video. In fact I may use it in our next ECG class as an example of what not to do. That was beyond "palming" and more like serious groping. Even a female caregiver doing the ECG should be cautious before doing that much handling of the breast to where it looks like you can't seem to take your hand off of it.

[JakeEMTP]

And to think the ambulance in the video was from the "hero's" at Seattle's own Medic One, the US leader in emergency care. Whatever helps you sleep at night.

Serious FAIL! Fondling your pt.'s breasts as demonstrated in the video is not necessary. Simply use the back of your hand, or your forearm (I know, but we've all done it) to allow for the correct placement. Be a professional.

[HERBIE1]

Just like a trauma patient, you have to expose. I don't see how you can get optimal placement of leads- especially the chest leads- without removing the bra. I don't know for sure, but wouldn't a bra with a metal wire also cause interference and artifact? Obviously you need to preserve dignity and the use of a towel or sheet is mandatory. As for using the back of the hand and/or forearm to move the breast, that was something I learned early on when working in an ER. Initially it was uncomfortable for me to do a 12 lead on a woman-especially one that was younger- so I can only imagine the discomfort and anxiety of the woman.

Yes, a woman with large breasts can be a challenge, but lead placement is no different. I actually saw someone try to place the leads on top of the breast because she was too nervous to move it. I corrected her, and said that like any other procedure, getting a poor result is no better than not doing the exam at all.

[spenac]

I actually saw someone try to place the leads on top of the breast because she was too nervous to move it. I corrected her, and said that like any other procedure, getting a poor result is no better than not doing the exam at all.

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.

[HERBIE1]

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 EKG tech that taught me told me exactly that- move the breast. I was told it's lazy and poor technique not to use the chest wall whenever possible.

[Lisa O]

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

[VentMedic]

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

Unless the implant that slipped down in the muscle, it is usually not an issue.

If one was to attempt to place an electrode on a silicone implant, it would mess up the voltage as would going across the breast tissue.