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Green Lake
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Darlington
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Camp Lake
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Reserve
Little Round Lake
Chief Lake
New Post
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Waterford NorthWind Lake
Eagle Lake
Bohners Lake
Browns Lake
Lac du Flambeau
Seymour
Tainter Lake
Odanah
Lake Wissota
HelenvilleLake Ripley
Hebron
Lake Koshkonong
Ixonia
Pell Lake
Potter Lake
ComoDelavan Lake
Rome
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Middle Village
Legend Lake
Neopit
Zoar
Keshena
Brice Prairie
French Island
Chain O' Lakes-King
Okauchee Lake
10 M
inutes20
Min
utes30 M
inutes40
Min
utes
UW Med Flight Transport Times
ES-40462-14uwhealth.org/medflight
V1: 4th ICSV2: 4th ICSV3: Between V2 and V4V4: 5th ICS MCLV5: 5th ICSV6: 5th ICS MAL
4
1
3
2
5 6
MCL
➞
➞
ECGs are Critical• Acquire ECG < 5 minutes• Relay findings to hospital immediately• Consider additional resources
ECG for all possible heart pain patients• Typical pain over age 30• Atypical symptoms over age 50
WHAT IS ISCHEMIA?• Partial blockage of blood
flow/inadequate blood supply• Decreased oxygen to heart• ST-segment depression• T-wave inversion
WHAT IS INFARCT?• Complete blockage of
flow/no blood supply• No oxygen supply to heart muscle• ST-segment elevation• Death of tissue/permanent after 12 hours
[SR] . Sinus rhythm[PLAE] . Probable left atrial enlargement[LVHCO] . LVH with IVCD and secondary repol abnrm[IMIAX] . Inferior infarct, acute (LCx)[NPR] * No previous record available for comparison.
458QTcF
2786160 24-Aug-2013 19:50:15NYGAARD, JOHN MDOB: 05-Oct-1954 58 Years Male Dept: OPD/ER
Oper: 043483
HR 62
PR 190QRSD 122QT 453QTcB 460
-- AXIS --P 60QRS 72T 113
Requested By: SCRATTISH, LOUIS
Order #: 63393508
Standard 12- ABNORMAL ECG -
Signed on behalf of: Makielski Jonathan 26-Aug-2013 08:52:59EditedUniversity of Wisconsin Hospital - UWHC (3-00-21)
I
II
III
aVR
aVL
aVF
V1
V2
V3
V4
V5
V6
II
Chest: 10 mm/mVLimb: 10 mm/mVSpeed: 25 mm/secDevice: 066630 F 60~ 0.15-150 Hz PH100B CL P?
ECG DIAGNOSIS OF ST ELEVATION MYOCARDIAL INFARCTION (STEMI)• One millimeter or more (one small box)• Present in two anatomically contiguous leads (next to one another on the heart)
[SR] . Sinus rhythm[PLAE] . Probable left atrial enlargement[LVHCO] . LVH with IVCD and secondary repol abnrm[IMIAX] . Inferior infarct, acute (LCx)[NPR] * No previous record available for comparison.
458QTcF
2786160 24-Aug-2013 19:50:15NYGAARD, JOHN MDOB: 05-Oct-1954 58 Years Male Dept: OPD/ER
Oper: 043483
HR 62
PR 190QRSD 122QT 453QTcB 460
-- AXIS --P 60QRS 72T 113
Requested By: SCRATTISH, LOUIS
Order #: 63393508
Standard 12- ABNORMAL ECG -
Signed on behalf of: Makielski Jonathan 26-Aug-2013 08:52:59EditedUniversity of Wisconsin Hospital - UWHC (3-00-21)
I
II
III
aVR
aVL
aVF
V1
V2
V3
V4
V5
V6
II
Chest: 10 mm/mVLimb: 10 mm/mVSpeed: 25 mm/secDevice: 066630 F 60~ 0.15-150 Hz PH100B CL P?
ES-40462-14
12 Lead Placement
MAL
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Typical heart attack symptoms• Chest pain or pressure• Pain in back, arms, shoulders,
jaw, neck and/or abdomen• Dyspnea• Diaphoresis• Palpitations• Nausea/vomiting
Atypical symptoms• Unusual fatigue• Weakness• Altered mental status• Dizziness• Syncope
Right coronary artery
Lateral wall
Septal wall
[SR] . Sinus rhythm[PLAE] . Probable left atrial enlargement[LVHCO] . LVH with IVCD and secondary repol abnrm[IMIAX] . Inferior infarct, acute (LCx)[NPR] * No previous record available for comparison.
458QTcF
2786160 24-Aug-2013 19:50:15NYGAARD, JOHN MDOB: 05-Oct-1954 58 Years Male Dept: OPD/ER
Oper: 043483
HR 62
PR 190QRSD 122QT 453QTcB 460
-- AXIS --P 60QRS 72T 113
Requested By: SCRATTISH, LOUIS
Order #: 63393508
Standard 12- ABNORMAL ECG -
Signed on behalf of: Makielski Jonathan 26-Aug-2013 08:52:59EditedUniversity of Wisconsin Hospital - UWHC (3-00-21)
I
II
III
aVR
aVL
aVF
V1
V2
V3
V4
V5
V6
II
Chest: 10 mm/mVLimb: 10 mm/mVSpeed: 25 mm/secDevice: 066630 F 60~ 0.15-150 Hz PH100B CL P?
Lateral
Inferior
Inferior
Inferior
Lateral
Septal
Anterior
Septal
Anterior
Lateral
Lateral
12 LEAD ECG AND CORRESPONDING HEART WALLS
ECG EXAMPLE: INFERIOR WALL STEMI
ES-40462-14uwhealth.org/medflight
STEMI 12 Lead Identification
Landing Zone Layout
<150 ft>
H+ ++
+ +➟
150 ft▲
▼
wind
➞
wind
➞
To arrange for transport, call the Access Center(800) 472-0111 or (608) 263-6796 (local)
Med Flight Radio FrequenciesMark II (151.280 tone 136.5), WI State EMS (155.340 no tone) or VHF 123.05
Landing Zone Prep• Hard, flat surface is preferred with NO
debris; AVOID tall grass/crops, mud, loose surfaces (sand, dirt, snow).
• Keep everyone and everything out of the LZ once established and until aircraft departs.
• Mark with cones during day, strobes at night.
• Avoid bright lights pointed upward.
Communication• Identify hazards.• Describe LZ and any landmarks. • If you cannot communicate directly with
the pilot, contact your Comm Center or Med Flight Comm Center to set up a phone relay.
• Vehicle mounted radios vs. handheld are preferred.
• When landing at an airport: no vehicles should be on runway, and no need to set up an LZ.
Approaching the Aircraft• NEVER approach the rear of the aircraft.• Do not approach the aircraft unless
directed to by Med Flight personnel.• Keep ALL vehicles 50 ft. from the aircraft.• Upon landing, the Med Flight crew will exit
the aircraft and come to you. • Do not bring the patient to the aircraft until
directed by Med Flight personnel.
ES-40462-14
Landing Zone Prep
uwhealth.org/medflight
