12-leads on routine respiratory calls?

[FireMedic65]

No disrespect meant towards you. I was just making a general statement, not specifically towards you. Sorry about the confusion.

no offense taken. i tend to read into things a little much. but i do agree with what you were saying. i got scolded because i apparently wasted time doing the 12-lead. when i had it all attached, and analyzed before BLS go there for transport. buuuuut im not ranting now

[canuckEMT]

Most of the time I will do a 12 lead on resp calls. I will usually wait until I am enroute to the hosp first as I like to get these pt's into the unit asap and do most of my interventions while trnasporting.

[croaker260]

Here is our guidelines for 12 leads where the complaint is other than a suspected MI (in other words all other medical patients)

12 lead ECGs: Also See Protocol C4 - General Cardiac Care.

The following patients should have a 12 lead ECG obtained by paramedic and

transmitted to the receiving hospital:

o Any non-trauma patient with primary complaint of chest pain

o Any patient with concern for cardiac etiology for their complaint (not

limited to AMI)

o Any patient with syncope

o Patients with primary complaint of Shortness of Breath and any of the

following factors:

? Diabetic

? Over the age of 65

? Altered Mental Status or Dementia

? History of Heart Disease

[AZCEP]

I'm a bit surprised that a guideline needed to be written into your protocols croaker.

It seems that "provider discretion" should have been included, but I suppose you have a pretty wide base to work from with what is there.

[croaker260]

I know I know...

Several things lead up to this..

1- Potential introduction of other agencies working under our SWO's.

2- two cases of "oh crap" that happened the month before this protocol was written. Cant go into details, but both cases were weird, and would have probably not had a 12 lead done by 90% of the medics here, and we havent had any (to my knowledge) miraculous catches since..but there it is.

Its about the only thing I didnt like, but considering everything else, its an acceptable loss. Remember also, we have deviation procedures and allowances...not thast I would use them on something so routine.

[AnthonyM83]

http://ladhs.org/ems/Manuals/medprotocols/ALS-12LeadEKG.pdf

[Asysin2leads]

On any respiratory call, if there is any question in my mind that the person needs a 12 lead, they get one. The 18 year old who is having an asthma attack isn't going to need a 12 lead, but a 45 year old who thinks they are having an asthma attack will. I have had at least one case on a non respiratory call where a second 12 lead enroute made a routine abdominal pain call into a person who was being prepped for the cath lab as soon as we got to the ER, so I am a big fan of them. I am also a firm believer in Murphy's Law, which is the one respiratory case I chalk up to BS and don't do a 12 lead on will be the one that bites me in the rear later.

[steph1030]

12 leads are done here if time alots they are very useful in diagnosing alot of things yes i agree they can be waranted with sob's and cps and very effective

sometimes i think people get tunnel vision and miss the obvious

if there is time there isnt a thing wrong with runnin a 12 lead esp if you have done all your priority stuff first

[Medic26]

Thanks to everyone for your input. Until recently I only performed them on classic presentations/suspected cardiac patients. I got burned twice in two weeks and after some discussion from this site I have been performing them on any respiratory patient as long as I have time.

I am currently pushing this issue with our service and medical director for my agency to make it standard care for all cardiac and respiratory patients. Any help with similar protocols or standards is appreciated.

[ccmedoc]

Is there a "routine" respiratory call??? :wink: