MCL1

[icekayak]

Just need a few opinions for an essay i'm writing...

With the common knowledge that lead II will not always show you what is going on in other areas of the heart, and rhythms such as VT are very difficult to differentitiate from SVT with aberrancy

In YOUR opinion should cardiac patients be routinely monitored in MCL1 in the pre-hospital setting? Why?

[gwrenn]

according to Bob Page, "lead II you don't have a clue"

MCL1 is the best indicator of LBBB vs VTach. You do not want to shock a left bundle branch block so look for the indicators in MCL1 and V6.

Go to Bob Page's web site and it explains more or get his 12 lead book.

gwrenn

[icekayak]

Yep, had a look round there thanks

But is MCL1 going to show you things like ST elevation and more of a general idea of the rhythm? or is is only useful for the LBBB/VTach/SVT?

Cheers

[scott33]

according to Bob Page, "lead II you don't have a clue"

MCL1 is the best indicator of LBBB vs VTach. You do not want to shock a left bundle branch block so look for the indicators in MCL1 and V6.

Go to Bob Page's web site and it explains more or get his 12 lead book.

Or equally as enlightening, attend one of his seminars. You will learn a lot about the benefits of continuous montoring on MCL1, as opposed to lead II.

[Ridryder 911]

I am an old ICU nurse, used to monitoring in MCL1 and like it; however it as well has its limitations. Personally, perform a XII lead, and identify the problems, then use the best appropriate lead (usually MCL).

R/r 911

[scott33]

Clearly nothing beats the 12-lead for the complete picture (well, perhaps a 15-lead).

As far as dynamic, or continual, monitoring goes, I think MCL1 has a lot of advantages over lead II for the reasons already mentioned above. As far as I am aware, there never has been any evidence to suggest that lead II is the best lead for continual monitoring. It just seems to be the way it ended up, seeing that we are creatures of habit with an aversion to change.