ECG (in Case of Emergency)

For the unconscious, the ECG should be derived as soon as an ECG is available. Initial is derived with the paddles of a defibrillator, later via patient cable. The heart rhythm and heart rate can be determined from the paddle ECG with a resulting derivation. From the ECG with patient cable one obtains 3 discharge channels, which correspond only approximately to the discharges I-II-III of the bipolar limb discharge after Einthofen of the standard ECG and therefore do not offer substantially more information.

The ECG strips obtained in this way are generally not suitable for infarct diagnosis. In recent years, 12-channel ECG leads have increasingly been used in rescue services, which improves infarct diagnostics. It should be noted, however, that infarct diagnosis cannot be improved by improved ECG derivation, but only by improved knowledge of ECG interpretation at the site of the emergency and infarct diagnosis by 12-channel derivation. If the emergency physician has little experience in ECG evaluation, the installation of a 12-channel ECG usually delays the course of therapy and diagnosis under certain circumstances without gaining additional information. In the USA, a 12-channel ECG is only evaluated by the cardiologist, to whom this ECG is sent by fax.