The other day I heard a story of an ED doctor geting angry at the paramedics who had brought in a cardiac arrest who the medics had had gotten pulses back on in the field. The doctor was angry because after he had done a 12-lead on the patient in the ED, he'd discovered the patient was a STEMI. He was furious that the medics hadn't done a 12-lead on the way in and discovered this themselves.
My initial reaction was what is he crazy? In 16 years as a medic I have never done a single 12-lead on any cardiac arrest I have rescusitated. Why not? Working as a single medic most of the time I am pretty busy with post-rescisitation care. That's my easy excuse, but I have done a number of rescusitations with other medics, and I have to say it has never occured to me to do a 12-lead. We are still usually too busy (shaking each other's hands), bagging the patient, hanging dopamine drips, etc, and remaining vigilant to losing pulses.
So, it is with great interest, I read the following article:EMS 12-leads after ROSC.
The bottom line for me in the article is a good number of these patient's are going to have ECGs showing a STEMI. It seems reasonable. There are probably many systems doing this routinely.
If possible, I will definately try to do one the next time I have a ROSC.
And I'll be curious if that knowledge will change the way the patient will be initially treated when I bring the patient in.
