👤 By the CinnaEMS Content Team🕐 Updated 2026-09-27🏷️ Cardiology & Resuscitation🔖 Free to read, print, and share
Also known as: ECG · EKG · 12-lead · rhythm · STEMI · VF
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Use this quick-reference guide to recognise, treat and hand over ECG Essentials on the NREMT and on the call. Keep it handy during review and on exam day!
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📒 The 1-minute cheat sheet
📌 Shock
VF · pulseless VT
✅ Don'T Shock
Asystole (confirm 2 leads) · PEA
📌 With A Pulse
Unstable fast → synchronized cardioversion
Peaked T → high potassium
📌 12-Lead
II, III, aVF inferior
V3–V4 anterior · I, aVL, V5–V6 lateral
📚 ECG Essentials — full study notes
The cheat sheet above is your quick recall card. These notes go deeper — what it is, what to do first, what changes the plan, and what to hand over.
Paramedic candidates are examined on the rhythms that change the next action: shockable versus non-shockable arrest rhythms, unstable rhythms with a pulse, and the 12-lead territories.
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Key points
Understand these first
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.
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Treatment priorities
What to do, in order
Check right-sided leads before nitrates in an inferior infarction.
Unsynchronized shocks are for pulseless rhythms only.
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Red flags — report now
Escalate immediately
Hypotension or altered mentation with any fast or slow rhythm
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Patient teaching
What patients must know
Epinephrine early in non-shockable arrest; after the first failed shock in shockable.
❓ ECG Essentials: NREMT 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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Quick Tip
VF and pulseless VT are shocked; asystole and PEA are not.