About EMS 12-Lead

Editor-in-ChiefTom Bouthillet - Editor-in-Chief

Tom Bouthillet is a Fire Captain / Paramedic in South Carolina where he is the Cardiac Care Program Manager of his department. He is Editor-in-Chief of ECGMedicalTraining.com and ACLSMedicalTraining.com, Co-Producer of the Code STEMI Web Series, and Author of the 12-Lead ECG Challenge app. He is a member of the Editorial Advisory Board of EMS World Magazine and author of the EMS 12-Lead column at EMS1.com. He has taught nationally in the Critical Care Transport (CCEMT-P) program out of UMBC and his writings have been referenced in the American Heart Journal, the Journal of the American College of Cardiology: Cardiovascular Interventions and the EP Lab Digest. Tom is interested in patient safety, human factors, simulation, team dynamics, process improvement, and system performance. He enjoys spending time with his wife Kelly and daughter Sydney.  All opinions expressed by Tom are his own and not the opinion of his employer.

Contact: Email, LinkedIn, Twitter, Facebook, Google+


David Baumrind - Associate Editor

Senior Editor

David Baumrind is a Paramedic in Eastern Long Island, New York where he is the STEMI/Cardiac Arrest coordinator for his department. David has spent the past several years studying 12 Lead ECGs and found the EMS 12-Lead blog early in his studies. David has been an active reader and frequent contributor, and began on the team as an Associate Editor in March 2010.

Contact: Email, Facebook



Christopher Watford - Associate Editor

Senior Editor

Christopher Watford is a Lieutenant / Paramedic and Board Member at Leland Volunteer Fire/Rescue Department (Leland, NC). At his day job, Christopher is a Lead Software Engineer with GE’s Global Nuclear Fuel – Americas and a Captain on their industrial fire brigade (Wilmington, NC). He also works part-time as a Paramedic for New Hanover Regional EMS (Wilmington, NC). Christopher found the EMS 12-Lead blog during paramedic school, has been an active reader and contributor, and began on the team as an Associate Editor in March 2010. All opinions expressed by Christopher are his own, and do not reflect the opinions of his employers.

Contact: Email, LinkedInFacebook


Senior EditorVinceD

Vince DiGiulio is an EMT-Critical Care in Binghamton, NY and has been an active reader and contributor to this blog ever since he was an EMT-Basic. Unlike most of the team he works almost exclusively inside the emergency department, affording him a slightly different experience when it comes to the evaluation, management, and disposition of acute-care patients. He also maintains a personal emergency medicine education blog called The Medial Approach to EM, along with several side-blogs linked there.

Contact: Email, Google+Twitter



Senior Editorivanr

Ivan J. Rios is a Cardiology and Electrophysiology enthusiast from Orlando, Fl and a loyal EMS12lead.com follower for over 4 years. He is a Critical Care Paramedic, currently working as a Paramedic/Field Training Officer for Sumter County, Fl, as well as an EMT and Paramedic Instructor at a local school, First Response Training Group. He has a great passion for Emergency Medicine and music, as an Acoustic Singer/Songwriter artist, know as Ivan J. Nash, by his local following.

Contact: Email, Google+



Senior EditorME-at the lake

Brooks Walsh is a board-certified emergency physician working in Connecticut. He studied the philosophy of physics in college (Bell’s  Theorem anyone?), and attempted a masters-degree program in pure mathematics. He found far more success in an EMT-B class, however,and spent the next eight years in EMS (five of those as a paramedic) working for private, volunteer, and hospital-based EMS agencies. He once led a traditional 5.10 route in New Hampshire (since downgraded to 5.9+ … ), has summited Denali, can often correctly use the subjunctive in Spanish, finished a marathon in 4:37, has a 2K erg time of 6:46, and is never, ever, sick at sea.

Contact: Email


  • L says:

    I have come across your web site many times and find it to be an awesome resource. Thank you and keep it up! Since HIPAA, I have found it difficult to follow up on patient outcomes-hence my learning was limited in that respect.
    Thank you again.

  • You’re welcome, L!

  • Jesse says:

    Just an off the wall question kinda related to this topic. I recently had an anterior MI new and evolving en route to the ED. Anyways everything went great cath lab and all the bells and whistles but my question was the Doc called the shape of this guys st segment a “sign” of some sort like a name of some famous doctor or something… I just cant remember what he said but I know it has to do with the type and shape being concave or convex or a specific type of st segment maybe only or usually found in anterior wall MI’s. I cant remember what he called it and I have heard it before. Anyone can help me out?

  • Christopher says:

    Perhaps Wellen’s T-waves?

  • Jesse says:

    Yes Wellen’s is correct. That what he said. You know a good site I can learn more about this or do you know a little bout it

  • Christopher says:

    Dr. Smith’s ECG Blog has at least one case featuring the evolution of Wellen’s T-waves. They are typically deeply inverted, symmetrical T-waves or biphasic T-waves in V2-V3, without the loss of R waves in those same leads. Often a sign of proximal LAD stenosis. Along with de Winter and Brugada, it is a shape of ST/T waves that you should become familiar with in the long term.

  • Leevy says:

    I was looking at your diagram for 12 leads placement..I counted only 10 sites..where are the other 2 electrodes or is it only 10 sites?

  • John says:

    I had a question.  I am doing a reasearch on time to prehospital 12 lead and I was wondering if you have studies that you are aware of that may be helpful.  I have looked at the usual places, pubmed, etc but have not found much.  Anything you can share would be appreciated.

  • Ryan says:

    10 sites are normal. These 'sites' to name them properly are called electrodes. An ECG Lead is made up by combining two of these electrodes.
    Basically the three electrodes placed on the right arm (RA), left arm (LA) and left leg (LL) are combined to make 3 lead views of the heart (leads I, II and III). The ECG machine then augments them to generate an additional 3 views (aVR, aVF and aVL), thus these three electrodes generate a total of 6 lead views of the heat. The chest leads V1 – V6 make up the other 6 views giving us a total of 12 leads from 9 electrode placements.
    The electrode on the RL is used only as an earth reference point.
    If you are interested to learn more you should do some reading on Einthoven's Triangle and Wilsons Central Terminal.

  • vanessa says:

    I need a a diagram showing where to put the leads  where can i find a picture?

  • Mike says:

    I sincerely appreciate all of the knowldege I've been able to gleen from your website. So that I might further develop my knowledge of interpreting 12 leads, is there a single-book resource you might recommend – something I can have as a "Universal Reference" for those hard to discern 12-leads?
    Thanks a million~~

  • James Pace says:

    Thank You Tom for your incredible lecture at the EMS Expo in New Orleans this past Thursday. I was in the front row with about 5 other co-workers some of who have 15+ years as ALS providers in EMS. I can honestly say that this was, hands down, the best/most concise 12-Lead lesson I have ever been exposed to. And this feeling was shared by all of my co-workers as we walked away from your lecture. Keep up the good work you all do in demystifying this topic and helping to change the way we look at this vital tool in our everyday assessments. J. Pace NREMT-P 

  • Shayna Orsen says:

    I learn something new from ya'll everyday! I'm a huge fan, and when I have questions you're my first resource for answers. Thanks so much for all you do! ~ Shayna Orsen NREMT-P

  • Jason Fawver says:

    Thank you for this outstanding site! Thanks for making it easier to understand the “basics” of 12 lead reading!

  • Audrie Wisell says:


    I am wondering if you could direct me to a source for information on prehospital care. I am a DNP student working on a QI project for my facility. I am aware that my local EMS (nearly all volunteer) rarely completes prehospital ECGs but I am trying to locate data for prehospital ECG completion at the Utah state and national levels.
    Any help that you could provide would be very helpful.

4 Trackbacks

Leave a Reply

Your email address will not be published. Required fields are marked *