12-Lead ECG FAQs

12-Lead ECG FAQs

If a medical facility or office has acquired a 12-lead prior to my arrival, should I still acquire and transmit one?

  • Yes, you should use the Lifepak 15 to acquire and transmit a 12-lead.

Once I have acquired a 12-lead do I take it off of the patient?

  • No, leave it on and allow it to continually monitor for changes.  If it detects a change in ST-elevation, it will automatically acquire and print out a new 12-lead — transmit that 12-lead to the hospital and call them on the radio for guidance.

If a BLS provider obtains a 12-lead, does that mean they should also request an ALS response?

  • Generally, yes.  If a BLS provider obtains a 12-lead they should consider requesting an ALS response using the same considerations (patient condition, location, time, distance, etc.) that they would use with any other patient.

If a BLS provider obtains a 12-lead where should it get transmitted and when?

  • The 12-lead should be transmitted to the closest (appropriate) receiving facility that the patient will be transported to; if ALS is responding it is acceptable to withhold transmitting until the ALS provider arrives and provides direction.

I’m an EMT.  If I obtain a 12-lead and it has “ACUTE MI” across the top of it, what do I do?

  • Make sure you’ve requested ALS and transport to a STEMI hospital (CGH, SLH, SVBGH). Treat the patient accordingly.

I’m an EMT and I can do 12-leads.  Does this mean I can monitor the patient via a 4-lead as well?

  • No, the protocols and scope of practice do not allow this.

If a BLS provider obtains a 12-lead does that mean an ALS provider that arrived on scene has to attend to the patient as the AIC for transport?

  • No, the ALS provider is expected to use sound clinical decision making skills with a comprehensive assessment of the patient and an evaluation of the totality of all circumstances.  The 12-lead findings should not be used as the sole determining factor.

Once an ALS provider obtains a 12-lead does that mean the ALS provider has to remain with that patient as the AIC for the transport?

  • No, obtaining a 12-lead is a BLS skill.  The 12-lead is an assessment tool to enhance clinical decision-making and should be used as a consideration and not as the sole factor.  The ALS provider is expected to use sound clinical decision-making skills with a comprehensive assessment of the patient and an evaluation of the totality of all circumstances prior to determining whether or not a patient may be transported “BLS”.

Where and/or how should 12-leads be documented in the ePCR?

  • Ideally, all Lifepak information should be downloaded directly from the monitor into the ePCR “Add or Edit LP15 Use” field.

Do I switch out monitors with the Fire Department?

  • No, transmit the 12-lead from their Lifepak (using your EMR notebook and cable), transfer the data and switch the patient over to your monitor.