12 Lead ECG in CEN

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.

Up Vote Up Vote ×
Specializes in EMS, ED, Trauma, CEN, CPEN, TCRN.

My advice is to learn how elevation in certain leads correlates to the part of the heart muscle that is damaged (i.e., inferior wall = II, III, and aVF), and then understanding which coronary arteries are likely to be occluded in such a situation. With that being said, I haven't taken my CEN yet, but I've done some practice CEN questions, and that's the kind of thing I've seen regarding 12 leads -- just some real basic stuff. If you read 12 leads in EMS, that'll help; if you didn't, then not so much. Good luck on your CEN! :)

Up Vote Up Vote ×
Specializes in Anesthesia, CTICU.

Hey QS,

If you read 12-Leads in EMS, you can pretty much stop right there. Only very basic knowledge is required... I took the CEN and did fine with not even reviewing the 12 -Leads, so I guess alot depends on your comfort level with them. As Lunah mentioned, you need to know the basic patterns of infarct.. II, III, aVF = inferior, etc..

which coronary artery is affected,

where would the reciprocal change be,

and initial course of treatment... is nitroglycerin appropriate, or a fluid challenge and dob?

I wouldn't stress beyond that for the CEN. Best of luck!

Up Vote Up Vote ×
Specializes in cardiothoracic surgery.

OK, dumb question. What is the CEN?

Up Vote Up Vote ×
OK, dumb question. What is the CEN?

It's the certification for emergency nurses.

Up Vote Up Vote ×
Specializes in EMS, ER.
OK, dumb question. What is the CEN?

It is a certification in Emergency Nursing granted by the Emergency Nurses Association:

http://www.ena.org/bcen/

Up Vote Up Vote ×

Wikipedia has some nice basic information. Scroll down to the clinical lead groups section. http://en.wikipedia.org/wiki/Electrocardiogram

You could also look in your hospital library for a book on it.

Up Vote Up Vote ×
Specializes in ER, Trauma, ICU/CCU/NICU, EMS, Transport.

Most everybody has done a good job responding.

I've done quite a bit of reading/reviewing on this while writing and publishing our CEN review course/manual.

The majority of 12-lead "core" ED nurse knowledge is to readily identify those major infarct/injury patterns and be able to anticipate particular interventions/treatments.

The main ones to know: Inferior, Septal, Anterior, Lateral ("I See All Leads"), and Posterior.

You should know which vessels affected: LAD, RCA, Circumflex.

And; be VERY familiar with your "routine" ACLS Lead II rhythms (Vfib, Vtach, Asystole, PEA, 1st/2nd/3rd Deg HB, Sbrady, Stach, SVT, PSVT etc)

Hope this helps....

-MB

http://www.bemetweb.blogspot.com/

Up Vote Up Vote ×

Do not neglect the RVI association with Inferior wall MI. The V4R question is making it's way into nearly every exam that tests emergency or critical care knowledge.

Up Vote Up Vote ×
Specializes in ER, Trauma, ICU/CCU/NICU, EMS, Transport.
Do not neglect the RVI association with Inferior wall MI. The V4R question is making it's way into nearly every exam that tests emergency or critical care knowledge.

Please explain the "V4R question" - ?

However I can assure people that there are no "new" questions on the CEN exam since Mid 2007.

The next revision is probably 3-4 years from now -that's when new questions will be put in place.

Up Vote Up Vote ×

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.

Up Vote Up Vote ×
Specializes in EMS, ED, Trauma, CEN, CPEN, TCRN.

I assume he's talking about flipping some of the precordial leads?

Up Vote Up Vote ×
+ Join the Discussion