Axis & Lead Placement
To view the High Lateral wall of the heart, you must look at these two specific leads.
What are Leads I and aVL?
The standard NREMT criteria for STEMI in most leads for a male over 40 is this much elevation in two contiguous leads.
What is 1 mm?
This common condition presents with diffuse, concave ST elevation in almost all leads and PR-segment depression.
What is Pericarditis?
hese are the two primary "shockable" cardiac arrest rhythms
What are Ventricular Fibrillation (VF) and Pulseless Ventricular Tachycardia (pVT)
QRS duration must be at least this wide to be considered a complete Bundle Branch Block.
What is 120 ms (0.12 seconds)?
This electrode is placed at the 4th intercostal space, just to the right of the sternum.
What is V1?
This "STEMI Equivalent" presents as ST-depression in V1–V3 with prominent, upright T-waves.
: What is a Posterior MI
Often seen in young, healthy athletes, this benign finding shows a "fishhook" notch at the J-point with ST elevation.
What is Benign Early Repolarization (BER)?
e 2025 guidelines emphasize that this drug should be given as soon as possible for non-shockable rhythms, but after the second shock for shockable rhythms.
What is Epinephrine?
When using the "Turn Signal" method in V1, a downward (QS) deflection indicates this type of block.
What is a Left Bundle Branch Block (LBBB)?
If Lead I is positive and Lead aVF is negative, the axis is shifted in this direction.
What is Left Axis Deviation (LAD)?
If you see ST elevation in the Inferior leads (II, III, aVF), you should look for reciprocal ST depression in this lead.
What is Lead aVL?
In the setting of high potassium (Hyperkalemia), the ST segment may disappear as the T-wave becomes "tented" and the QRS merges with it, creating this pattern.
What is a Sine Wave?
The maximum total dose of Atropine for a patient in symptomatic Bradycardia.
What is 3 mg?
To differentiate between a Right and Left BBB, paramedics should primarily look at the terminal (last) deflection of the QRS in this specific lead.
What is Lead V1?
To identify a suspected Posterior MI, a paramedic should move leads V4, V5, and V6 to these specific anatomical locations.
What are the Left Scapular Line (V7), Tip of Scapula (V8), and Left Paraspinal region (V9)?
Reciprocal changes in an Anterior MI (V1-V4) are typically seen in these leads.
What are the Inferior leads (II, III, aVF)?
During a code, your $EtCO2$ suddenly jumps from 12 mmHg to 42 mmHg. This is the most likely physiological event occurring.
What is ROSC (Return of Spontaneous Circulation)
This is the preferred antiarrhythmic dose for stable Monomorphic V-Tach with a pulse.
What is Amiodarone 150 mg IV over 10 minutes?
you arrive to find a 65 y/o male collapsed. The monitor shows Ventricular Fibrillation. You deliver the first shock. What is your immediate next step?
What is resume high-quality CPR? (Do not check a pulse or rhythm immediately after a shock).
Extreme Right Axis Deviation (the "No Man's Land" axis) is often a hallmark of this life-threatening toxicological emergency.
What is Tricyclic Antidepressant (TCA) Overdose?
This phenomenon occurs when ST depression in one area of the heart is actually the "mirror image" of ST elevation in the opposite wall.
Reciprocal Change
After 2 minutes of CPR, the monitor shows a narrow-complex rhythm at a rate of 80. You cannot feel a carotid pulse. What is this rhythm and your next drug?
What is PEA (Pulseless Electrical Activity) and Epinephrine 1mg
This medication is the first choice for a stable patient with narrow-complex SVT, administered as a rapid 6mg bolus.
What is Adenosine?
In the setting of an unstable, shockable SVT (not VF/VT), the "Sync" button must be active to avoid delivering the shock on this part of the ECG cycle.
What is the T-Wave? (To avoid R-on-T leading to VF).