- Suspected cardiac patient.
- Suspected tricyclic overdose.
- Electrical injuries.
- Assess patient and monitor cardiac status.
- Administer Oxygen as patient condition warrants.
- If patient is unstable, definitive treatment is the priority. If patient is stable or stabilized after treatment, perform a 12-Lead EKG.
- Prepare EKG monitor and connect patient cable with electrodes.
- Enter the required patient information (patient name, etc.) into the EKG device.
- Expose chest and prep as necessary. Modesty of the patient should be respected.
- Apply chest leads and extremity leads using the following landmarks:
- RA: Right arm
- LA: Left arm
- RL: Right leg
- LL: Left leg
- V1: 4th intercostal space at right sternal border
- V2: 4th intercostal space at left sternal border
- V3: Directly between V2 and V4
- V4: 5th intercostal space at midclavicular line
- V5: Level with V4 at left anterior axillary line
- V6: Level with V5 at left midaxillary line
- Instruct the patient to remain still.
- Press the appropriate button to acquire the 12-Lead EKG.
- If the monitor detects signal noise (such as patient motion or a disconnected electrode), the lead acquisition will be interrupted until the noise is removed.
- If an inferior infarct is suspected, obtain a right-sided and posterior (15-Lead) EKG.
For a 15-Lead EKG apply chest leads using the following landmarks:
- V7: Use lead V4 and place on left side 5th intercostal space at midclavicular line
- V8: Use lead V5 and place under left scapula at midclavicular line
- V9: Use lead V6 and place under tip of left scapula
- Once acquired, transmit the 12-Lead EKG data by fax to the appropriate hospital and notify the hospital of the 12- Lead EKG transmission. Do not transmit the 15-Lead EKG.
- Monitor the patient while continuing with the treatment protocol.
- Download data as per guidelines and attach a copy of the EKG’s to the patient care report (PCR).
- Document the procedure, time, and results on/with the PCR.