12 and 15 Lead Acquisition

1. 12 and 15 Lead Acquisition STEMI Recognition Class

2. 12 Lead Rapid Acquisition • Module 1 Electrode Location • Module 2 Electrode Placement • Module 3 How to do a 15 Lead • Module 4 Demonstrations • Module 5 Reducing Artifact • Module 6 Tips and Techniques

3. Module 1 Electrode Location Electrodes must be placed in the proper position to obtain an accurate 12 Lead ECG

4. Module 1 Electrode Location 12 leads obtained from 10 electrodes • 4 on the limbs • 6 on the chest

5. Module 1 Electrode Location Limb lead positioning is simple. The electrodes are placed off the torso, on the limbs. The most correct positioning is near the wrist and ankles. However, EMS generally places the electrodes on/near the torso to limit artifact while transporting.

6. Module 1 Electrode Location Chest leads have specific anatomic locations V1, V2, V4 the rest are placed in relationship to these leads

7. Module 1 Electrode Location

8. Module 1 Electrode Location

9. Module 1 Electrode Location

10. Module 1 Electrode Location

11. Module 1 Electrode Location

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14. Module 1 Electrode Location

15. Module 2 Electrode Placement • The key to correctly placing the chest electrodes is finding the 4th intercostal space

16. Module 2 Electrode Placement

17. Module 2 Electrode Placement

18. Module 2 Electrode Placement Here’s another approach to locating the 4th intercostal space

19. Module 2 Electrode Placement Best view laterally

20. Module 2 Electrode Placement • Locate the supersternal notch (1) at the top of the manubrium • Palpate down appox 2” until you find the sternal angle, slide your finger laterally to the right, you’re finger is now on the 2nd rib • Palpate down into the 2nd 3rd and 4th intercostal space 1

21. Module 2 Electrode Placement After placing V2, palpated down to the 5th intercostal space midclavicular line and place V4

22. Module 2 Electrode Placement V1 V4 V4R 15 Leads are simple Remove V4 and move it 5th intercostal space, midclivicular on the Right side of Pt’s chest V2 V3

23. Module 2 Electrode Placement 15 Leads are simple Remove V4 and move it 5th intercostal space, midclavicular on the Right side of Pt’s chest

24. Module 2 Electrode Placement

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28. Module 2 Electrode Placement

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32. Module 2 Electrode Placement

33. Module 3 Demonstrations

34. Module 3 Demonstrations

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36. Module 3 Demonstrations

37. Module 3 Demonstrations

38. Module 3 Demonstrations

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40. Module 3 Demonstrations

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42. Module 3 Demonstrations

43. Module 3 Demonstrations If you were the patient, where would you prefer to have you’re 12 Lead done, in the house or in the truck?

44. Module 3 Demonstrations There’s a lot of people out there and they can see into the ambulance. You should obtain the 12 lead in the house

45. Module 3 Demonstrations

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50. Module 3 Demonstrations