Category: triage

ECG placement & mis-LEADing ECG’s

  • V1: 4th intercostal space (ICS), RIGHT margin of the sternum
  • V2: 4th ICS along the LEFT margin of the sternum
  • V4: 5th ICS, mid-clavicular line
  • V3: midway between V2 and V4
  • V5: 5th ICS, anterior axillary line (same level as V4)
  • V7: Left posterior axillary line, in the same horizontal plane as V6.
  • V8: Tip of the left scapula, in the same horizontal plane as V6.
  • V9: Left paraspinal region, in the same horizontal plane as V6.

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Digital ECG

Digital ECG has now gone live on both sites.

We now have no excuse for loosing ECGs and not sending them to the wards with patients!

Please ensure you put an operator ID in as well as all the patient information to ensure the ECG transmits to EPR – if you are having problems look at the troubleshooting guide on the side of the machine.

Ensure a doctor/ACP signs all ECGs using EPR – just like when they were paper!

Quick Reference and Trouble Shooting Guide are available here  Digital ECG Quick reference guide

The SOP for reviewing and signing ECGs is available here Digital ECG SOP

 

Ordering X-Rays from Triage

Be specific

  • Subtle fractures are hard to pick up – especially if the wrong X-Ray is requested. Ordering the right X-Ray helps patients.
  • Finger injury – request X-Ray Finger(specific), NOT a hand (they are different views and often of little use)
  • Wrist injury – request X-Ray Wrist NOT Radius & Ulna
    • You can request they include the distal half of radius and ulna if the pain covers that area but still request a wrist

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