12 leads on females

[theotherphil]

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.

I've seen a few people mention this and I thought I'd share something from a Consultant Cardiologist when teaching on my ECG course. He told me that having the correct landmarks is more important that the slight change in amplitude caused by reading through breast tissue.

"Breast tissue appears to have a practically negligible effect on ECG amplitudes, and in women, the placement of chest electrodes on the breast rather than under the breast is recommended in order to facilitate the precision of electrode placement at the correct horizontal level and at the correct lateral positions."

Rautaharju PM, Park L, Rautaharju FS, Crow R. A standardized procedure for locating and documenting ECG chest electrode positions: consideration of the effect of breast tissue on ECG amplitudes in women. J Electrocardiol. 1998 Jan;31(1):17-29.

[Suburban/Rural Medic]

theotherphil, can you post a link to that journal? It seems worth reading.

To the original poster; in reference to landmarks and placement. Don't be afraid to actually palpate the ribs to ensure you are over the proper intercostal spaces. Place V4 before V3 and place V6 before V5. Be sure to shave the men well when necessary and do your best to dry off the clammy or diaphoretic patients. As far as privacy goes, there's nothing I can think of that hasn't been said. Most important is to explain to the patient where you're going to touch before you touch it, and to use the back of your hands to gently lift the breasts when necessary.

[Richard B the EMT]

Cross Reference to this other string, especially as to placement under or on top of the breasts. She'll need us soon, and I don't envy that crew for treatment or transport.

http://www.emtcity.com/index.php/topic/17937-new-jersey-woman-wants-to-weigh-1000-pounds/page__pid__237982__st__0&#entry237982