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Is continuous normal ECG data required to be documentation on the ACR

Question# 817

With rhythm analysis, if the initial one added to the ACR is normal, and throughout the call/transport, if the rhythm remains normal, do you have to continue to upload the ECG to the call to show it continues to be normal, or is the initial rhythm plus documentation it remained normal enough?


The ACR Completion manual requires that "any associated biometric data shall be included with the ACR". There are two parts to including the data: (1) upload and attachment of the data to the ACR; and (2) documenting the data and paramedic analysis.

Upload and attachment

Inclusion of biometric data from the monitor occurs when the monitor data is uploaded to the computer and attached to the ACR. Regardless of what is selected into the ACR procedures section, all uploaded and attached biometric data is then included, in the back end.
For this reason, it is ideal to upload monitor data after the monitoring period or as close to the end of monitoring as practical (upload may need to occur before monitoring completion to use offload delay time for ACR completion).

The paramedic selects which attached biometric data to document in the ACR procedures section.
If the ECG is normal and does not change during the call, in most cases, only the initial rhythm analysis needs to be documented.
An exception is when the patient condition requires specific reanalysis, this should be documented; e.g. all analyses of serial 12-lead ECGs in a suspected cardiac ischemia should be documented even if the ECG remains normal.

Upload, attachment, and selection of biometric data is based on iMedic, we are not sure how this function works in Prehos, but the requirements for documentation and inclusion are the same.
If your service has stricter documentation requirements, please follow them.


ACR Completion Manual, Part 5
BLS Chest Pain (Non-Traumatic) Standard


11 June 2024

ALSPCS Version




Please reference the MOST RECENT ALS PCS for updates and changes to these directives.