INTRODUCTION

Cardiac monitoring is a skill recommended in all patients suspected of having cardiopulmonary disease as a primary or contributory part of their disease process, as well as, any patient in which cardiac complications are anticipated, as a result of their disease, mechanism of injury, or treatment. The Paramedic may apply a cardiac monitor to any patient where cardiac monitoring would enhance their care.

1. Application & Recording
   1. Primary leads will be limb leads I, II, & III.
   2. Recording should be done liberally during patient care.
   3. Record before and after any medication administration.
   4. Use the strip for notes as needed.
   5. Include the Code Summary or a reasonable sample of the available ECG strips with the EMS report.
   6. The patient care record should have the paramedic's interpretation of the ECG recorded as well.

2. 12 Lead ECG Recording
   1. A 12 Lead ECG shall be aquired on patient's presenting with signs & symptoms of an Acute Myocardial Infarction.
   2. The EMS crew should not delay patient care or transport to aquire the ECG.
   3. When possible provide 2 paramedics, one can manage patient therapies, while the other acquires the 12 lead ECG.
   4. Once a reading has been acquired, FAX the ECG to the Emergency Department As Soon As Time Allows.

1. Remember, 1 in 4 ECG's do not show significant changes in the setting of myocardial infarction. Do Not use ECG findings alone, to alter treatment of chest pain.