Garbage In Garbage Out: The Critical Role of Proper EKG Acquisition in Accurate STEMI Identification

EMS professional spend a great deal of time learning to interpret EKGs. This is based upon the fundamental importance of the skill, particularly in accurately assessing for STEMI but also rhythm diagnosis and for such things as cardiotoxicity from toxins. In all of these applications, the assumption is that the EKG itself has been obtained in the prescribed manner, which includes skin prep and proper lead placement. The failure to provide good skin prep is often a reason for artifact; this is sometimes apparent. However lead placement and patient positioning are other critical factors that are not as easily seen on the EKG and, if done improperly can cause a false negative or a false positive STEMI. This talk provides fundamental information on skin prep (alcohol wipes and even a quick scrape with electrode holder are insufficient!) and lead placement that many assume they know but come to find out that their skills could improve.