Standards Procedure (Skill) of ECG

Clinical Indications:
Ø Known or Suspected Cardiac Patient
Ø Known or Suspected Tricyclic Overdose
Ø Electrical Injuries
Ø Syncope

Procedure:

a. Assess patient and monitor cardiac status.

b. Administer oxygen per patient condition as tolerated.

c. If patient is unstable, definitive treatment is the priority. If the patient is stable or stabilized after treatment, perform a 12-lead ECG.

d. Prepare ECG monitor and pre-cordial lead cables.

e. Enter patient demographic data.

f. Expose the chest and prep as necessary. Modesty should be considered.

g. Apply chest leads and limb leads as follows:

v RA----right arm

v LA----left arm

v RL----right leg

v LL----left leg

v V1----4th intercostal space at right sternal border

v V2----4th intercostal space at left sternal border

v V3----Directly between V2 and V4

v V4----5th intercostal space at midclavicular line

v V5----Level with V4 at the left anterior axillary line

v V6----Level with V5 at the left midaxillary line

h. Instruct patient to remain still.

i. Press the 12 lead acquisition button on the monitor.

j. If the monitor detects a problem, such as loose leads, bad connection, noisy data, the monitor will alarm. The EMT-P should address the problem.

k. Once acquired, transmit to the appropriate receiving facility.

l. Contact the receiving facility to notify them of the patient and the incoming 12-lead.

m. Monitor and reassess the patient enroute and continue treatment protocol.

n. Attach a copy of the 12-lead with the patient’s record at the hospital.

o. Document the procedure, time, results and findings on the ACR.