12-leads on routine respiratory calls?

[Medic26]

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

I used to think so, but not now. This just goes to show that you never stop learning and growing as a provider.

[RedZone]

Where I am, it's not common practice to do a 12 lead except if an MI is suspected, and only if the patient is hemodynamically stable. Honestly, I never understood that since our interpretation of the 12-lead has no effect on the treatment we provide, and hospitals I work with usually couldn't care less about seeing my 12-lead. I have always looked at it merely as a way of documenting the location of the infarct, and to warn us to be careful with NTG if it is an inferior wall MI.

Of course, if a patient is complaining of chest pain and a non-cardiac cause is pretty much evident, I will still do a 12 lead. I would like to think that this is standard practice now among my colleagues, but I am sure there are a few that wouldn't do this. One medical director actually had to require 12 leads "for any chest pain in a patient over 35 or with cardiac history" (keep in mind he may have made that requirement when the technology was new to us 10 years ago).

My only training with 12 lead interpretation (and I have been to more than one class, at least one was by an ED physician active with EMS) has been to look for ST segment elevations and depressions. I am glad I got bored the last few days! Now that I have been looking through EMS forums, I see that I should look into expanding my competency a little in this area. That should help with the boredom too!

[HellsBells]

interpretation of the 12-lead has no effect on the treatment we provide, and hospitals I work with usually couldn't care less about seeing my 12-lead. I have always looked at it merely as a way of documenting the location of the infarct, and to warn us to be careful with NTG if it is an inferior wall MI.

Well Redzone, I'd say that you have contradicted yourself, obviously withholding or limiting your Nitro would count as an effect on treatment. In our Urban system, the 12-lead is very important for the outcome of a pt. STEMI patients have to be transported to the one hospital in our city with Cath lab facilities. Additionally, a lot of ambulance services, particularly rural ones are administering thrombolytics, so the 12-lead is becoming a much more important tool in EMS care.

I do agree that hospitals will always take their own 12-leads, no matter what ours say. I imagine its a CYA issue, but the quality of their hospital machines is usually much better than those we use prehospital. Even with perfect placement, I often find it frustrating trying to obtain a 12-lead without artifact on an LP12.

Now, Redzone, seeing that your post was written about 2 years ago Id like to know if your opinion, and/or knowledge of 12-leads has changed in any way. That is presuming you still post on this site.

[msenecal]

I never say always but I tend to lean towards doing a 12lead with my respiratory patients. The respiratory and the circulatory system rely on each other to compensate for any of the others short comings. I would hope you are at least putting a 4 lead on, and does it really take that much longer to add 6 more?

[Dustdevil]

Too much Timmy's, HellsBells?

RedZone: Last active Oct 13 2007 06:14 AM

Edited January 19, 2010 by Dustdevil

[HellsBells]

Ok... safe to say Redzone will not be in on further disscussion