Transmitting EKGs

[mikie]

I have heard of transmitting EKGs to hospital from the field, how is this done? How does it go from being on a monitor and converted over radio waves to paper?

And when is usually a time EKGs are transmitted? I know my protocols about when to be transmitted, just wondering other dept/SOP/SOG ?

Thanks!

 

[Jon]

Around here... the Lifepak 12's can send 12-leads by phone. One option is to plug the LP12 into a phone jack. It dials a fax machine in the ED, and sends the 12 lead as a fax to a fax machine. Another is via cellular, where a cell phone attached to the monitor sends the message to the fax machine, so you don't need a landline phone handy.

In the old days, the signal was sent over the radio as "telemetry". Most places have stopped that, because the EMT-P should be able to read arrhythmias.

Locally, the transmitting feature is used for a 12 lead that the EMT-P is concerned about, if possible. This means that when the medic calls command, the doc can LOOK at the 12 lead, and perhaps even activate a cath lab team prior to EMS arrival at the ED.

 

[Ridryder911]

LP 12 can also be "blue toothed" . They have a program for the receiving hospital, in which can be transmitted to the cath lab, or wherever need be. As well, it can be immediately "downloaded" for ePCR's.

Many services do not use transmission because most Paramedics can interpret ECG's fairly decent.

R/r 911

 

[Outbac1]

What Jon said is pretty much the way we do it here. Every LP12 has a cell phone. Here our ACPs read 12 leads but PCPs are not required. As we do not yet carry fibrinolytics on the truck, 12 leads can be sent to the ER ahead of time.

 

[Grady_emt]

We use our LP12s bluetooth and a paired phone that stays with that LP12 to send 12 leads on all STEMI pts to the ER where the ER attending will review and pre-activate the cath team who meets us upon arrival in ER if not already on a case.

 

[Niftymedic911]

We have no need for transmission of ECG's in the field here. We used to have it with the cellular phones...... But since we have the Zoll's with 12-lead capability and each paramedic is subject to an extensive 12-lead course and rhythm interpretation course prior to credentialing..... There isn't really a need. If a STEMI is present and meets criteria, STEMI alert is called, at which our dispatch then notifies the hospital to activate the cath lab prior to EMS arrival. When we call STEMI alert there must be at the very least 1mm elevation to 2 or more consecutive leads with reciprocal changes in opposite leads. (Meaning, II,III, AvF (Inferior) elevation with reciprocal changes in V4,V5,V6.... STEMI Alert or V2, V3, V4 (Septal) with further ST wave changes in other leads.... (STEMI)

We are however with our new EPCR program ImageTrend EMS Field Bridge, our Zoll's and hammerheads will be able to communicate with bluetooth. It will automatically upload rhythm strips, 12-leads, and vitals signs into the procedures area of the EPCR. No more having to manually enter info in ) We'll also be able to upload our PCR's from our hammerhead wirelessly with a secured WiFi network within our truck. Our new Toughbook 30's and hammerheads come with WiFi capabilites and Sprint cards.

 

[reaper]

Nifty,

You actually have to wait for reciprocal changes to occur, before calling a STEMI? They can be late signs.

We still transmit all 12 leads in a STEMI. Not because the Dr's don't trust the medics, they like to compare it to old 12 leads prior to arrival.

 

[Niftymedic911]

I'm sorry reaper........ Didn't mean to mislead. Omit the reciprocal changes part of my post..... I too agree that reciprocal changes are often late ominous signs and mis understood my protocol after I re-read it. (I'm in the FTO program currently for medic) If they're having elevation greater then 1 mm I'm calling it period end of story.

48's straight sucks sometimes........ OT junkie......

 

[Markhk]

Is anyone calling in a STEMI alert when they see a LBBB? I'd just be curious since we can't really tell if New Onset Left Bundle Branch Blocks is "new onset".

 

[Ridryder911]

No. LBB and a true ST elevation is much different. I understand the importance of a new onset of LBB but realistically how many patients know if they have had a LBB or not? (unless previous tx for CHF)

R/r 911

 

[firecoins]

how are you suppossed to know if LBBB is new? Do people keep copies of old 12 leads around?

 

[Ridryder911]

how are you suppossed to know if LBBB is new? Do people keep copies of old 12 leads around?

Well actually some do with chronic cardiac problems as well as there are many that now keep their old ECG's on a memory stick that can be plugged into your computer.

LBB is important because one technically cannot determine ST elevation in some leads. However; experience will tell you the difference and to examine the other leads. Again H & P is essential in cardiac (as other medical calls) and recognizing the medications they are placed upon.

R/r 911

 

[bonedog]

"hammerheads will be able to communicate with bluetooth"

We have trouble getting the hoser's to turn their portables down...