BEorP Posted October 12, 2006 Share Posted October 12, 2006 Hopefully I can make my question make sense... We've recently started learning about 12 leads and were taught that they have "diagnostic quality" if we find ST elevation in two contiguous leads to suspect an MI. What I am wondering is if with just a 3 lead you could conclude that someone is having (at least) an inferior wall infarct if there is elevation in leads II and III? (I'm not saying that this would rule out any other areas of infarct or be a reason not to do a 12 lead if you had the capabilities though.) I was told by an instructor that you cannot because a 3 lead does not have the "diagnostic quality" of a 12 lead monitor, but that didn't seem to make much sense to me... are leads II and III shown differently (or more clearly) on a 12 lead? If we could say a pt is having an inferior wall infarct from elevation in leads II and III in a 12 lead, why could you not do this with just a 3 lead? Thanks Link to comment Share on other sites More sharing options...
Equivalentrade Posted October 12, 2006 Share Posted October 12, 2006 The way I see it, more points of reference = More information. I dunno ^^ Im sure someone more experienced can help! Link to comment Share on other sites More sharing options...
Ridryder 911 Posted October 12, 2006 Share Posted October 12, 2006 I suggest to look at multiple lead... yes, it's nice to have XII lead, but one can determine by moving the leads around and looking specifically without diagnostic setting. Check out Bob Pages web site : http://www.multileadmedics.com/ R/r 911 Link to comment Share on other sites More sharing options...
AZCEP Posted October 12, 2006 Share Posted October 12, 2006 Depending on the equipment you are using, diagnostic and monitor quality usually refers to the electrical spectrum that the monitor views in. Some are adjustable to work in diagnostic mode when utilizing limb leads, some will only do so when analyzing a twelve lead. Monitor quality is a range of 1-30 MHz, while diagnostic is 0.5-45 MHz. The wider range that is allowed in diagnostic mode, allows a better picture of the electrical events. Link to comment Share on other sites More sharing options...
BEorP Posted October 12, 2006 Author Share Posted October 12, 2006 Thanks for all the replies. Link to comment Share on other sites More sharing options...
akroeze Posted October 12, 2006 Share Posted October 12, 2006 Thanks for all the replies. I appreciate the replies too, but they all aren't answering the question as far as I can tell. They are all basically saying it would be best to do a XII lead... which we already know. I'm interested in this too because I think I'm going to be working for a service without XII lead with lengthy transports. Is this not a question that can get a yes/no answer? If I put the limb leads in diagnostic mode and see indication in II and III can I say it's as good as the same changes on a true XII lead? Link to comment Share on other sites More sharing options...
northernmedic Posted October 12, 2006 Share Posted October 12, 2006 I would say no, you can't make that diagnosis base only on 2 leads. Personally I would but more stock in your clinical assessment of the patient's presentation, in particular the history to help you make a decision. If you see ST changes in lead II or III it would highly elevate your suspicion but I don't think you can definitively diagnose STEMI. Link to comment Share on other sites More sharing options...
BEorP Posted October 12, 2006 Author Share Posted October 12, 2006 I would say no, you can't make that diagnosis base only on 2 leads. Personally I would but more stock in your clinical assessment of the patient's presentation, in particular the history to help you make a decision. If you see ST changes in lead II or III it would highly elevate your suspicion but I don't think you can definitively diagnose STEMI. My question wasn't really about whether or not seeing elevation in two contiguous leads is enough to have a high suspicion of MI since that is what we have been taught. My question was, assuming you can have a high suspicion of MI from elevation in leads II and III when seen on a 12 lead, could you have the same suspicion based on leads II and III from just a 3 lead. I don't mean to say that ST elevation in two leads can definitively diagnose MI though because obviously there are other things that can produce ST elevation. It seems like AZCEP answered my question by basically saying that it depends on the monitor that you are using since some might actually have a lover quality when only doing a 3 lead... hopefully I've understood this correctly. Link to comment Share on other sites More sharing options...
nsmedic393 Posted October 12, 2006 Share Posted October 12, 2006 I know our LP12s can be turned onto diagnostic mode is you can find the right buttons. The answer is yes...However if your machine will not print in diagnostic mode any ST elevation you may see means little to nothing. Link to comment Share on other sites More sharing options...
northernmedic Posted October 12, 2006 Share Posted October 12, 2006 NSmedic is right about diagnostic mode. The LP12 will print in diagnostic mode so it can be used in this capacity. I can't speak to the Zoll monitors since my service used all medtronic products. Link to comment Share on other sites More sharing options...
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