Advanced 12-Lead ECG Interpretation


ACCF/AHA 2013 Guidelines for the Management of ST Elevation Myocardial Infarction (2013, p. e371), “EMS personnel should be accountable for obtaining a prehospital ECG, making the diagnosis, activating the system, and deciding whether to transport the patient to a PCI-capable or non–PCI-capable hospital.”  Without question, this directive places the responsibility for diagnosing acute coronary artery occlusions squarely on prehospital providers.  To meet this responsibility and ultimately improve outcomes in these patients, the EMS provider must become proficient in use and analysis of the primary screening tool for acute coronary artery occlusions: the 12 Lead ECG. This 8 hour course is designed for Paramedics, Nurses, and other advanced care providers interested in improving 12 Lead interpretation competency beyond traditional STEMI recognition.  This course includes a great primer in electrophysiology and ECG waveform analysis -with the goal being to not only recognize important ECG changes such as QRS duration and morphology, J point and ST segment elevation and depression, hyper acute T wave and other T wave changes, QRS axis, and injury axis – but to understand why these changes occur with respect to lead placement and cardiac pathology.  

With a solid foundation in 12 lead waveform understanding, in addition to reviewing the latest STEMI diagnostic criteria from the 2013 ACCF/AHA STEMI Management Guidelines, this course will cover proper lead placement, limitations and common errors of 12 Lead acquisition, QRS axis and hemilblocks, identifying STEMI mimics, Lead aVR in left main and proximal LAD occlusion, and finally cover in detail the STEMI equivalents:  acute occlusion in the presence of LBBB and paced rhythm using the Modified Sgarbossa Criteria, acute occlusion in Benign Early Repolarization, and the Isolated Posterior MI.  Ample practice using paper ECGs is required so please bring your calipers!

O’Gara, P. (2012). 2013 ACCF/AHA Guideline for the Management of ST-Elevation Myocardial Infarction. Circulation, 127(4), E362-E425. Retrieved April 28, 2015, from html

8.0 hours Cardiovascular CEUs awarded.   This course is approved for UMBC CCEMT-P and BCCTPC FP-C renewal hours.

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