12-Lead EKG Guidelines

12-Lead EKG Guidelines

  1. BLS providers can obtain and transmit a 12-lead once they have received VBEMS-specific training and (approval); and in accordance with the following TEMS protocols:
  • Adult and/or Pediatric Bradycardia
  • Adult and/or Pediatric Tachycardia (stable)
  • ROSC
  • Altered Mental Status
  • Breathing Difficulty
  • Cerebral Vascular Accident
  • Chest Pain / AMI / ACS
  • Dialysis / Renal Failure
  • Electrical / Lightning Injuries
  • Hyperthermia
  1. If a BLS provider obtains a 12-lead in accordance with the aforementioned protocols, then they should also request an ALS response using the same considerations (location, time, distance, etc) that they would use with any other patient whom they determine would require an ALS response.
  2. If BLS performs a 12-lead, then it should get transmitted to the closest (appropriate) receiving facility. The BLS provider(s) should be sure to tell the ALS provider once (if) they arrive on scene or notify the hospital during the radio report.
  3. BLS cannot monitor a patient via 4-lead.
  4. ALS providers should perform 12-leads in accordance with the above TEMS protocols and any other patient they deem necessary (reference previous 12-lead guidance).
  5. The ALS AIC should not solely use 12-lead EKG findings to determine whether or not to turn the patient over to a BLS crew.
  6. Simply obtaining a 12-lead EKG does not necessarily mean the patient warrants an ALS transport; 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.
  7. The 12-lead EKG should be documented in the “Add or Edit LP15 Use” field.

STEMI