Acquiring A 12 Lead ECG By The EMT-basic
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While on an EMS run, a 60 year old male complains of shortness of breath with pain in his jaw traveling down to his left arm. He is also complaining of intermittent nausea. He appears to be sweaty and apprehensive. After acquiring the LP15 and equipment, you decide to take a 12 lead ECG per protocol. The first thing to do after explaining the procedure to the patient is to:
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Make sure that patient assisted nitroglycerin and aspirin are administered to the patient before obtaining the ECG.
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Prep the skin by lightly scrubbing it with an alcohol and gauze pad for good electrode contact.
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Wait for ALS personnel to arrive on scene since they can analyze the ECG.
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Shave off very light hair on the patient's chest in non-essential areas.
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It will soon be one week since the training session on 12 Lead ECG acquisition by the EMT-B. As a method to evaluate your new knowledge please take the following brief quiz. Feedback will be provided and is only intended to reinforce key points from the session.
Quiz Preview
- 2.
There are ____ limb leads and ____chest leads to place before acquiring the 12 lead ECG.
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6,6
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2,8
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4,6
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4,8
Correct Answer
A. 4,6Explanation
The correct answer is 4,6. This means that before acquiring the 12 lead ECG, there are 4 limb leads and 6 chest leads that need to be placed. The limb leads are placed on the arms and legs, while the chest leads are placed on specific locations on the chest. These leads help to capture the electrical activity of the heart from different angles, providing a more comprehensive view of the heart's function.Rate this question:
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- 3.
For patient comfort while placing electrodes, it helps to:
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Gently press the electrodes onto the chest without the lead wires attached.
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Firmly press the electrodes onto the chest; then attach the lead wires.
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Pre-attach the lead wires to the electrodes before placement onto the chest.
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Let the patient place the electrodes onto his/her chest with direction from the EMT.
Correct Answer
A. Pre-attach the lead wires to the electrodes before placement onto the chest.Explanation
Pre-attaching the lead wires to the electrodes before placing them onto the chest helps to improve patient comfort. This allows the EMT to simply position the electrodes onto the chest without having to apply additional pressure or attach the wires afterwards. This method minimizes any discomfort or potential pain that may be caused by pressing the electrodes onto the chest.Rate this question:
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- 4.
Which of the following items increase the likelihood that a clear 12 lead ECG tracing is acquired?
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Skin preparation to remove oils, shaving excessively hairy areas on the chest.
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Having the patient in a reclining position and remaining still.
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Having the squad driver pause at a stop sign or briefly pulling off the street.
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All these are important in obtaining a clear ECG reading.
Correct Answer
A. All these are important in obtaining a clear ECG reading.Explanation
Skin preparation to remove oils and shaving excessively hairy areas on the chest help in improving the contact between the skin and the electrodes, resulting in a clearer ECG tracing. Having the patient in a reclining position and remaining still reduces movement artifacts, which can interfere with the accuracy of the ECG. Pausing at a stop sign or briefly pulling off the street helps to minimize motion artifacts caused by the movement of the vehicle. Therefore, all these measures are important in obtaining a clear ECG reading.Rate this question:
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- 5.
Obtaining more than one 12 lead ECG tracing is desirable during the EMS run with a suspected AMI patient.
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True - the ECG can change over time and with EMS treatment; comparison of previous 12 leads is beneficial.
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False - one ECG is usually sufficient; others delay patient transport.
Correct Answer
A. True - the ECG can change over time and with EMS treatment; comparison of previous 12 leads is beneficial.Explanation
Obtaining more than one 12 lead ECG tracing is desirable during the EMS run with a suspected AMI patient because the ECG can change over time and with EMS treatment. Comparing previous 12 leads can be beneficial in monitoring the patient's condition and evaluating the effectiveness of the treatment.Rate this question:
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- 6.
A helpful memory aid to place the limb leads is the statement:
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White over right, smoke (black) over fire (red).
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Red is right, black is over white.
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White is right, red (fire) over smoke (black).
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Green is ground, fire and smoke calls for an engine.
Correct Answer
A. White over right, smoke (black) over fire (red).Explanation
This statement serves as a helpful memory aid for placing the limb leads correctly. It reminds us that the white lead should be placed over the right side of the body, while the black lead should be placed over the left side of the body where the heart is located. This is important for obtaining accurate readings during an electrocardiogram (ECG) test.Rate this question:
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- 7.
When placing limb and chest leads, correct placement of electrodes is important. We locate landmarks by identifying which areas of the chest?
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Xiphoid process, sternum, humerus, umbilicus
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Hands, feet, ribs, shoulder blades, sternum
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Clavicles, chest, intercostal spaces, sternum, axillary
Correct Answer
A. Clavicles, chest, intercostal spaces, sternum, axillaryExplanation
When placing limb and chest leads, correct placement of electrodes is important. The correct answer is "clavicles, chest, intercostal spaces, sternum, axillary." These are the areas of the chest where landmarks are located to ensure accurate placement of the electrodes. The clavicles, chest, sternum, and axillary regions provide reference points for electrode placement, while the intercostal spaces help determine the correct positioning between the ribs.Rate this question:
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- 8.
When placing chest leads, we are primarily concerned with locating which areas?
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2nd and 3rd intercostal spaces
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4th and 5th intercostal spaces
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Mid-clavicular and mid-axillary points (only)
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1st and 2nd intercostal spaces
Correct Answer
A. 4th and 5th intercostal spacesExplanation
When placing chest leads, we are primarily concerned with locating the 4th and 5th intercostal spaces. These spaces are important for accurate placement of the leads to obtain the best electrical activity of the heart. The leads are typically placed in specific positions on the chest to capture the electrical signals from different areas of the heart. The 4th and 5th intercostal spaces are commonly used because they provide good access to the heart and are close to the anatomical location of the heart's electrical activity.Rate this question:
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- 9.
After placement of the limb and chest leads, you press the 12 lead button on the LP15, and the screen reads "noisy" or "unable to obtain". Which of the following might be reasons the LP15 did not acquire the reading?
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The patient was raising his head to see what was happening and was pulling on the cot side bars.
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An electrode was not firmly attached to the patient's chest.
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You were operating the suction machine directly over the LP15.
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All of these (and more) may affect the LP15 from acquiring the reading/tracing.
Correct Answer
A. All of these (and more) may affect the LP15 from acquiring the reading/tracing.Explanation
The LP15 may not have been able to acquire the reading/tracing due to various reasons. One possible reason is that the patient was raising his head and pulling on the cot side bars, which could have caused movement and interference with the electrode placement. Another reason could be that an electrode was not firmly attached to the patient's chest, resulting in poor contact and signal quality. Additionally, operating the suction machine directly over the LP15 could have caused electrical interference and disrupted the reading. There may be other factors not mentioned that could also affect the LP15's ability to acquire the reading/tracing.Rate this question:
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- 10.
Which of the following statements best sums up the need for all EMS providers to have the ability to acquire/transmit a 12 lead ECG when a suspected acute myocardial infarction may be taking place?
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Time is muscle; identifying patients for quicker reperfusion therapy is the goal.
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Acquiring a 12 lead ECG may change our treatment in the field for suspected AMI patients.
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Acquiring a 12 lead ECG requires much greater on scene time and should only be utilized when it is clear the patient is experiencing an AMI.
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Its always nice to keep up on the latest technology.
Correct Answer
A. Time is muscle; identifying patients for quicker reperfusion therapy is the goal.Explanation
Acquiring/transmitting a 12 lead ECG is necessary for all EMS providers because time is crucial in treating acute myocardial infarction (AMI). The statement implies that the faster patients can be identified for reperfusion therapy, the better the chances of saving heart muscle. Acquiring a 12 lead ECG in the field can potentially change the treatment approach for suspected AMI patients, allowing for quicker and more appropriate interventions. This emphasizes the importance of EMS providers having the ability to perform this procedure.Rate this question:
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- 11.
I mentioned STEMI in the lecture on 12 lead ECG acquisition. What does the abbreviation STEMI mean? (Yes, I know you aren't allowed to interpret the ECG). Note: this is a "gimme" question, but all EMS personnel should have an awareness of STEMI.
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Stop The Enlarging Man Inside
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ST (segment) Elevation Myocardial Infarction
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ST Ending Myocardial Infarction
Correct Answer
A. ST (segment) Elevation Myocardial InfarctionExplanation
The correct answer is ST (segment) Elevation Myocardial Infarction. This abbreviation refers to a specific type of heart attack where there is a blockage in one of the coronary arteries, leading to a lack of blood flow to the heart muscle. The ST segment on an ECG represents the time between ventricular depolarization and repolarization, and elevation of this segment can indicate myocardial infarction. It is important for EMS personnel to be aware of STEMI as it requires immediate medical intervention.Rate this question:
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- 12.
According to Ohio Scope of Practice Laws, which statement(s) are true of EMT-Basics obtaining 12 lead ECGs?
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Unnecessary delays for transporting the patient are avoided.
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Written protocol and authorization by medical direction exists.
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The 12 lead is for transmitting to the ED.
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All these are true statements.
Correct Answer
A. All these are true statements.Explanation
EMT-Basics obtaining 12 lead ECGs can avoid unnecessary delays in patient transportation. This is because they can quickly assess the patient's condition and transmit the 12 lead ECG to the emergency department (ED) for further evaluation. This process is supported by written protocols and authorization from medical direction, ensuring that EMT-Basics are trained and authorized to perform this task. Therefore, all the given statements are true.Rate this question:
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Mar 22, 2023Quiz Edited by
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Feb 26, 2012Quiz Created by
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