Archive for October2008

Cardiac Axis Determination – Part 3

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In Part 2 we discussed the heart’s mean electrical vector and how Einthoven’s Triangle (leads I, II, and III) can be redrawn to form the first 3 spokes of the hexaxial reference system. Essentially, we ended up with a shape like the one on the right. When leads I, II, and III are drawn this […]

Cardiac Axis Determination – Part 2

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In Part 1, we looked at Einthoven’s Equilateral Triangle and Einthoven’s Law, and I told you that it was the key to understanding the formation of the hexaxial reference system. But before we delve further into the hexaxial reference system (the instrument we’ll be using to calculate the heart’s QRS axis) we need to address […]

Cardiac Axis Determination – Part 1

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Few subjects related to 12 lead ECG interpretation provoke more controversy (or anxiety) than axis determination. It is controversial in that not everyone agrees it is a necessary skill for prehospital providers to learn. It is anxiety provoking in that it can be difficult to understand, especially when taught poorly. I am of the opinion […]


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*** Preserved for historical purposes only. *** Greetings! Welcome to the Prehospital 12 Lead ECG blog. My name is Tom Bouthillet. I’m a Fire Lieutenant / Paramedic with the Town of Hilton Head Island, Fire & Rescue Division. I’m an Advanced Cardiac Life Support Instructor and I’ve taught the management of Acute Coronary Syndromes and […]

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