The 12-lead ECG Helps Save Lives in the Hospital and in the Field - Essay Example

A 12-lead ECG is good for patients who had got an obvious chest pain and carry a high risk for an acute heart attack even without chest pain. It is valuable for the detection and accurate diagnosis of arrhythmia because multi-lead recordings provide evidence of P wave and QRS complex morphology that cannot be determined from two or three-channel recordings. Besides, the 12-lead recording represents a potentially unified signal acquisition method that can be utilized for ambulatory recording. Obtaining a 12-lead ECG when an AMI is suspected is obviously warranted and beneficial.

Further evidence can be had from two case histories. In one case as cited in the Journal of Emergency Medical Services (August 2005), Dr. Marc Eckstein reports of a 47-year-old man who complained of substernal chest pain. There was no past medical or social history. The crew conducted a physical exam and the vital signs were normal. After the initial care they received instructions from their base station to administer a second dose of NIG 0.4 mg and repeat doses every three to five minutes, and morphine sulfate 4 mg via IVP.

The post-arrest ECG showed large ST elevations in the precordial leads. An ECG only five minutes later demonstrated a ‘tombstone’ pattern and indicated a massive MI. The patient was immediately taken to the cardiac cath lab and his angiogram revealed a 90% occlusion of his left anterior descending (LAD) coronary artery, which was successfully opened with angioplasty and stented. An aortic balloon was inserted and he was transferred to the CICU. He regained conscious later in the day and eventually made a complete recovery.

In another case (Medtronic Physio-Control) a patient of 56 years with no previous cardiac history, was having chest pain for almost two hours. The paramedics arrived in four minutes and found him conscious and complaining of moderate chest pain. He appeared gray and ill. After immediately placing him on oxygen and the cardiac monitor, which showed a normal sinus rhythm in Lead II, Frank was prepared for the eight-minute transport to the nearest hospital emergency department.