12 leads on females

[bullet498]

So I'm a new EMT-I and was looking for advice for applying 12 leads on female pt's especially those that are of larger size

thanks

[letmesleep]

Explain the procedure.

Remove all clothing......this includes the bra.

Find and follow your landmarks.

Place your leads.

Acquire your data.

Is this what you were asking? Nothing should change just because your dealing with a woman......large or not.

Let me know if your needing something other than my response.

[fireflymedic]

Often if the female is larger busted and the caregiver is male (and I follow the same even being a female) - if the patient is alert, I will ask them to lift the breast to preserve dignity and also prevent the question of you doing something inappropriate. I am guessing this is more what you were asking?

[tom5706]

Often if the female is larger busted and the caregiver is male (and I follow the same even being a female) - if the patient is alert, I will ask them to lift the breast to preserve dignity and also prevent the question of you doing something inappropriate. I am guessing this is more what you were asking?

Here are the tips from one of the best

[VentMedic]

You do not have to make a public viewing for the whole FD and neighborhood when you disrobe the patient. Even in an emergency you can still protect the patient's privacy within reason especially with everyone having a cellphone and access to youtube these days. Even a towel across the chest can offer some privacy and give you access for placement. Even if the person is having an MI, there is no need to cause more anxiety than absolutely necessary.

If possible, approach from the patient's left side so you do not have to clumsily reach over the patient.

Avoid "palming" the breast. Try to only contact with the back of your hand and use clothes, towel or sheet to move the breast or have the patient move it.

Is this what you were asking? Nothing should change just because your dealing with a woman......large or not.

I guess you wouldn't mind have 10 firemen stripping off your clothes to display your pride and joy to all the gawkers including children in a public place?

It only takes a few seconds to be mindful of one's privacy.

Edited January 19, 2010 by VentMedic

[fiznat]

Do you guys really always remove the bra? I almost never do. I know someone is going to say that you cant get good quality or placement with the bra on but I don't seem to have too much trouble with it...

[VentMedic]

Do you guys really always remove the bra? I almost never do. I know someone is going to say that you cant get good quality or placement with the bra on but I don't seem to have too much trouble with it...

Leave it only if you can get near exact placement for V1, V2 and V3 as well the the others. Usually the bra can be unhooked and not fully removed. If you are off on your placement in any way, it will skew the analysis. If you do continue on with the 12-lead without proper placement, write on the print out which electrodes were malpositioned. A good Cardiologist can usually tell "sloppy" work but if you make them aware of it beforehand, they may cut you some slack and just use the ECG for rhythm analysis and do the diagnostics off the one done at the hospital.

[letmesleep]

I guess you wouldn't mind have 10 firemen stripping off your clothes to display your pride and joy to all the gawkers including children in a public place?

It only takes a few seconds to be mindful of one's privacy.

Ok, good catch! I agree with maintaining the pt's modesty from gawkers, as well as, their privacy. I truly didn't think I'd have to remind a "professional" of those issues. Honestly the OP's question doesn't seem complete to me (no offense).

Vent, you seem a little pissy tonight.

[VentMedic]

Vent, you seem a little pissy tonight.

Apologies.

I spent too much time reading posts on another forum that have left me disheartened for lack of better words.

So, never assume "professional" will always be mentioned in the schools or on the job.

This is also a common and obvious question that should have been addressed extensively in the OP's program with even a possible demonstration.

Edited January 19, 2010 by VentMedic

[tskstorm]

To the OP, This is part of your job, don't be bashful and don't be a child, just do your job and act professionally.

For those that are uncomfortable removing the bra completely or in the situation where everyone is around and towels etc... are not at your disposal, you can always just lift the "under-wire" and place your leads. This however can leave you with more artifact then usual, but this is the exception on how to do a 12 lead not the rule.

Appropriate placement requires bra removal or unfastening at minimum. As far as privacy I know every system is different, however 99.5% of the time, If doing a 12 lead, it is just my partner and I (Double medic trucks) present. FD is no where to be found, they may have responded and been first on scene but they are almost immediately released soon as the ALS or BLS show up. On occasion a BLS crew will be there also however we just ask them to step out, unless 1 is a female, and then we have the BLS female stay, and 1 Medic, this doesn't really improve the patients privacy but it does limit who is there, and helps against anything looking inappropriate.

Once again, be professional and do your job, treat your patients the same no matter the sex, and when faced with these situations, remain professional and learn from senior EMTs/Medics.