Paramedics Course – ECG (Part 5) STEMI

ECG (Part 5) STEMI

Micro-lecture by the Australian Paramedical College


In today’s micro-lecture, Australian Paramedical College Hon. Snr. Lecturer Sam Willis talks about how to manage the ECG and STEMI.


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ECG (Part 5) STEMI

In today’s micro-lecture, we’re going to talk about the J Point. Now in previous ECG lectures, we’ve already talked about the voltage, time, PR Interval, the P Wave, the Q, R, S.

And now we need to move this conversation on a little bit more to try and help you guys to recognise an ST Segment, that’s this part here; elevation, that’s when the J Point elevates more than two small squares; Myocardial Infarction, so STEMI. STEMI is what we know as an acute coronary syndrome that we’ve talked about before. And that you have probably read about as well.

So let’s talk about that in a little bit more detail. On every ECG, you will see this thing called a J Point. Here it is on this side, here it is on this side. Now the J Point just refers to that little area there. So in other words, whenever you use that word, those terms, J Point or somebody else uses those terms, always only ever referring to that part there.

Now on this normal ECG, notice how this line stays consistently straight. However, somebody’s who’s having a STEMI, this J Point raises above the ECG at least two small squares. So that would be what we call a STEMI.

So let me show you what that looks like here. So on this image you can clearly see the J Point, which is here. And it’s more than two small squares above the line. Now here we have the line. Yes it’s a little bit wobbly and shaky, ECG lines of people having STEMIs are very rarely flat like the image that you just saw. They usually have some kind of movement or artifact.

Then you have the P Wave. Now there’s no Q Wave, but that’s fine. Don’t worry about that. R, S, and then here we have the J Point. Now the J Point should be down here, but it’s not. It’s one, two, three, and a little bit above the isoelectric line. So this is what we call a STEMI.

Well it’s at least a ST Segment elevation. For it to be a STEMI, the myocardial infarction, it has to be … you have to see this in a number of different leads. Which we’re not talking about here.

So this a ST Segment elevation. There’s the J Point, it’s more than two small squares above the isoelectric line. Just be mindful, guys, that with this image of the STEMIs, they can always present themselves in slightly different presentations. So they don’t always look like what I’ve just shown you.

All you need to do is type in STEMI into the Google search engine and go to images. And you can see all these different … we use the term morphology. So that just means pattern, different patterns of STEMI. These are all STEMI. There’s the J Point there. More than two small squares.

So again, that’s J Point and STEMIs.

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