Top 10 Do’s and Don’ts of Obtaining an ECG

If you’ve ever wondered what all those leads and sticky dots were doing when placed over a patient in a hospital or in a film then they were probably having their heart monitored.  And by monitored, they were probably having some form of ECG (Electrocardiogram . . . with a C, for Cardio.  Not EKG, like how the septics spell.  ECG!).

ECG’s are a fantastic system used in lots of hospital and pre-hospital environments to help determine cardiological issues and help us determine the correct course of treatment and outcome for the patient.

They measure the electrical output of the heart and we do this by strategically placing several (10 in the UK) sticky dots attached to leads, over the patient’s chest and limbs.  And, after the patient remains still, we gain a readout from the Lifepak machine that gives us 12 different views of the heart.  This is when we, the clinicians, pretend to know what we’re looking at.

So below, to help anyone who might be in the remote bit interested, I’ve put together a quick Top 10 Do’s and Don’ts of how to ECG . . .

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19th Floor – Lift Broken

The tower block loomed in front of me, like a gigantic mountain sized monolith.  Due to a power cut, not a single light was on throughout the building.  This just added to its dark and evil mystique.  My eyes slowly moved up the floors searching for its peak.  But against the dark London back drop, the building seemed to blend as one with the night sky.

Somewhere up on the 19th floor, someone had turned their ankle and was in “so much pain, they could not walk”.  So, standing with my paramedic bag on my back and all the other essentials I always took into jobs, I prepared to enter the building.

“You going up there mate?”  A young resident was leaving the building and had clocked me with all my kit.  He was motioning up the building.
“Yep.  Are the lifts working?”
“Ha!  No chance mate.  Nothing is.  It’s all fucked yeh”

I looked up once again and did a quick calculation in my head.  Within seconds I was sat back in the car calling up control.  Sod that, walking up 19 floors with all that kit!

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PEP – Post Exposure Prophylaxis

My breathing quickened and shallowed.  I was aware that I was becoming sweaty and that my arms and legs were feeling like lead weights.  Tingles began to creep from the ends of my fingers through my hands and slowly up my arms.

Slumping further into the chair, I desperately tried to keep my head up but waves of nausea began to take control.

“You sure you’re alright Binder?  You really don’t look well you know.  I think we should get you to lie down”

“I’m fine . . . honest . . . ” I lied.

And before I could give myself in to a good old fashioned fainting, the HART* guys picked me up and ‘assisted’ me to the mess room sofa where I lay for the next half hour slowly recovering.

An hour after taking my first round of Post Exposure Prophylaxis medicine and I was reduced to a gibbering wreck whereby my “life” had just been saved by HART.  Oh, the humanity.

Pic courtesy of @LAS_HART

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“Urgent police please” – a Section 136

We have a coded phrase in the LAS, that when spoken on priority or on open mic, will alert whoever is listening that urgent police are required and needed on the hurry up!  It’s used so that attackers don’t obviously know you are calling for help.  Unfortunately, not everyone in the LAS knows about this.
Just so there is continued secrecy to that phrase I have used the phrase, VECTOR VECTOR instead . . . as it’s equally as stupid as the real one.

As the woman sat on the floor screaming, the two men set about beating her again.  This time, I acted instinctively – I’d had enough.  And, rushing forward I placed myself between the screaming woman and the two men.

“Get back!”  I pushed them back a step or two and pressed priority on my radio – nothing.

The two men charged at the same time, one brandishing a walking crutch above his head as if to strike.  This time, with instinct, I open-hand pushed both men away in their faces, pushing one to the floor.

“Get BACK!!!” I shouted and again pressed priority on my radio – nothing again!

I was now consciously aware of the ludicrousness of the situation.  Here I was, maintaining a heroic side ward stance, one hand outstretched to the two men stood, poised ready to pounce either side of me.  Whilst my other hand was outstretched to the woman sat cowering behind me on the floor.  Some might of suggested this was the epitome of chivalry and heroism, like a Mexican standoff . . . but really, this was nothing more than a ridiculous end to a pathetic situation which I really wish I’d never been sent to in the first place!

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Teaching an old dog new tricks . . .

Over the police radio we could hear carnage and mayhem.  Someone, somewhere, was being stabbed.  Multiple times.  And it was happening right now.

Over the top of police shouting for urgent assistance, were the screams of anguish, pain and despair.

As I buckled up, I nodded at Terry*, who was in the driver’s seat, “Right!  Terry, ready?  Let’s go!”.

Terry was brand new to our Unit and tonight was his first ever JRU shift.  Terry nodded back and started the engine! . . .

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The first episode of this documentary came out last week.  I only got round to watching it after it had aired, as a friend contacted me saying they were currently watching it.

BBC One – Ambulance – documentary

Image result for bbc ambulance documentary

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