LP 15 without 12 Lead capabilities?

[island emt]

Our hospital based Paramedic interceptor car just got a new decked out LP15. It was $35k and change with all the options. That was hospital pricing.

It has all non invasive functions and the new Masimo CO monitor.

I've always known that you Canukistanians get robbed on medical equipment.

[Arctickat]

Chuckle, that's why many owners I know used to buy their ambulances from the States.

[DwayneEMTP]

Thanks all...

Yeah, I was surprised. I've not worked in a hospital based system, so I guess I've never really thought of a monitor as not being able to do a 12lead. You can view all 12 leads, just not print them out together.

I wonder, is it really a 12lead then? Are the leads still filtered the same as if it was a 12 lead? I'm not opposed to moving a lead around to get the information that I need, but if they don't have the advanced filtering, then I've not really gained much, right?

Not sure...probably talking out of my ass.

DFIB, I hear you. Though I do go to some pretty primitive places, the company that I work for, normally, has a pretty interesting way of setting things up. The client is responsible for all costs of the clinic. They write my company a blank check and my company builds them the clinic that they want. As many of the clients are really big oil, gas, and gold producers, the clinics are often really, really nice! Staffed with docs and nurses...unfortunately, I've only worked in one of the nicer clinics, in Mongolia, but have passed through many on the way to the dumpy, dirty, single man clinic that I'm assigned to. :-)

And for the record, for the last nine months I've been putting on the little brass bells with the suction cups for a 12 lead, but at least I had friggin' 12 lead capabilities!

[mobey]

Dwayne i feel old...

What you are discusing is called a "9 lead" ECG. I used to do them regularly before we had 12 leads.

Back in the day Tniuqs and I had a great discussion about them on here, but it will be long gone.

As a challenge, I would love to see a new EMT-P on here describe for us exactly how to do one!

The downfall is that if you do not enter "diagnostic mode" with the machine (something that happends automatically when you hit the 12 lead button when equipped) then the print-outs are not really diagnostic because they are filtered.

This accounts for the ocasions when you see huge ST elevations when monitoring lead II, yet the 12lead shows none (or visa-versa).

Now, on to the challenge:

[Arctickat]

I remember doing that with the 12 lead add-on box for the LP10.

[DwayneEMTP]

I hear you Moebes, but this isn't a monitor from someone's attic, it's an LP15!

Do you guys know, as we can see all 12 leads individually, if they are filtered the same as the 12 lead?

This is probably horribly stupid, but can you have 12 unfiltered "rhythm strips" if the machine isn't running the 12lead algorythms?

[BEorP]

I wonder, is it really a 12lead then? Are the leads still filtered the same as if it was a 12 lead? I'm not opposed to moving a lead around to get the information that I need, but if they don't have the advanced filtering, then I've not really gained much, right?

I don't have a source to back this up, but I remember asking a similar question in paramedic school seven years ago. There weren't many services in the area that had 12 lead capable monitors at the time, so I wondered whether even without moving the leads around if you saw elevation in leads II and III that that would be diagnostic of an MI as elevation in two contiguous leads on a proper 12 lead is. The answer I was given was absolutely not because a 3 lead ECG lacks the "diagnostic quality" of a 12 lead. They said basically that you shouldn't think much of elevation that is just seen on a 3 lead ECG.

So in response to your question, I would say that I think doing the leads individually will likely not be helpful (but this is going off of just what I was told many years ago and nothing that I have read myself).

I know we probably don't want to be sending people off to other forums, but the other major EMS forum has a section where a proper PhysioControl rep will answer questions. They might be able to get you a proper answer from PhysioControl on this, along with the actual scientific justification.

[mobey]

Do you guys know, as we can see all 12 leads individually, if they are filtered the same as the 12 lead?

Can't believe no one has told us how to do a 9 lead yet!

The answer to this question is "No"

When you press the "12 lead" button, all filters are removed.

Since doing a 9 lead is simply moving electrodes around, but staying in "Lead II" the filter is still there, and therefore the ECG is non-diagnostic.

If you google "McL leads" you should find some decent info....

Sorry, usually I would be all over this and take the time to explain all this, but I have just taken on a new position running a station and am barely treading water this month.

[DwayneEMTP]

Yeah, see. I was afraid of that...

So, not having a diagnostic mode, what does that mean to our interpratation of elevations/depressions, recipricals, etc?

You know, I'm just going to show myself an idiot for the good of the cause, as I'm sure that I should know these things...but, the fact is, that I don't.

Thanks for your help everyone! This thread isn't exactly a barn burner, but I like it a lot...

[DFIB]

The real question is, do you secretly enjoy the hickey producing suction cups?