12 Lead ECG in CEN

Specialties Emergency

Published

I am thinking about taking the CEN soon and it seems that the only trouble I am having is the questions regarding the 12 lead ECG. Anyone have any advice on how to better prepare for this, or is this not that big of an issue in the test....I have been on the job for over a year, but have several years EMS experience behind me...Any help would be appreciated.

Specializes in ER, Trauma, ICU/CCU/NICU, EMS, Transport.
Assessing V4R in the setting of inferior wall MI to rule out RVI.

Edit: This is not a new concept; however, it can easily be missed as the RV does not fall into the generic ISAL assessment.

In the classes we teach, the assessment for RVI does fall into the "generic" ISAL under discussion of IWMI.

One would be remiss if they didn't discuss it as part of that.

We don't teach just doing V4R however, we do teach that "if" you have an inferior infarct pattern, to get a complete R side EKG, (not just V4R) and look for the changes in V4R, V5R and V6R.

I still think the emphasis should be on V4R. By it's self, V4R is about 90% specific and sensitive to the detection of RVI. While a complete right sided ECG is good, V4R is the priority.

While associating RVI with IWMI is good, we must emphasize RVI is only present in 30-50% of IWMI cases, therefore, I still believe RVI is a very special condition.

Specializes in M/S, Tele, Peds, ER.

Just FYI, to learn EKGs back and forth a great resource is "Rapid Interpretation of EKG's" by Dale Dubin, MD... I'm using that plus taking an EKG course

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