Key takeaway
VF and pulseless VT are shocked; asystole and PEA are not.
Key points to remember
- VF and pulseless VT are shocked; asystole and PEA are not.
- Confirm asystole in more than one lead and check the connections.
- Unstable tachycardia with a pulse: synchronized cardioversion.
- II, III and aVF are inferior; V1–V2 septal; V3–V4 anterior; I, aVL, V5–V6 lateral.
- Peaked T waves with a widening QRS suggest high potassium.
Field priorities
- Check right-sided leads before nitrates in an inferior infarction.
- Unsynchronized shocks are for pulseless rhythms only.
Coaching the patient
- Epinephrine early in non-shockable arrest; after the first failed shock in shockable.
Red flags: act now
- Hypotension or altered mentation with any fast or slow rhythm
ECG Essentials: FAQs
What are the priority actions for ECG Essentials in the field?
Check right-sided leads before nitrates in an inferior infarction. Unsynchronized shocks are for pulseless rhythms only.
What findings in ECG Essentials change your plan or your transport decision?
Hypotension or altered mentation with any fast or slow rhythm.
What do I need to know about ECG Essentials for the NREMT?
VF and pulseless VT are shocked; asystole and PEA are not. Confirm asystole in more than one lead and check the connections. Unstable tachycardia with a pulse: synchronized cardioversion. II, III and aVF are inferior; V1–V2 septal; V3–V4 anterior; I, aVL, V5–V6 lateral.
What should the crew communicate or document for ECG Essentials?
Epinephrine early in non-shockable arrest; after the first failed shock in shockable.
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