PhEDECs™ – level 1

12-lead ECG acquisition and interpretation is a fundamental part of effective emergency medical care and a professional requirement for both prehospital and emergency department staff.    


PhEDECs™ comprises three levels, reflective of the three levels of practice seen in prehospital and in-hospital emergency medicine. The course content is mapped to HCPC (Paramedics) and NMC (Nursing) Standards of Proficiency, as well as the RCEM EM Trainee and EC-ACP curricula.  

PhEDECs™ syllabus (full)


Course overview



Silas Houghton Budd DipECG

Specialist paramedic (critical care)


Jamie Webb

Specialist paramedic

(urgent and emergency care)


The aim of PhEDECs™ level 1 is to ensure learners have a

comprehensive understanding of 12-lead ECG fundamentals,

can systematically identify normal sinus rhythm, and can

recognise common life-threatening problems.

Entry criteria

PhEDECs™ level 1 is aimed at clinicians fulfilling levels 3–4 on the

Skills for Health Career Framework. Examples include:

  • Prehospital

    • Ambulance Technician

    • Associate Ambulance Practitioner

    • Newly Qualified Paramedic

  • In-hospital: 

    • Newly Qualified Nurse

    • Foundation Doctor (years 1 and 2)


Please note: learners should review the PhEDECs pre-learning material 

(or similar) prior to attending as these fundamental concepts will not be revisited.

Learning outcomes

  • Understand the ‘medical model’ / patient clerking and where the 12-lead ECG fits within the model

  • Recognise signs and symptoms of cardiac problems

  • Appreciate the importance of repeat ECGs and dynamic changes

  • Understand relevant cardiac anatomy: location in chest, coronary artery territories and the conduction system

  • Understand relevant cardiac physiology: electrical and circulatory

  • Understand basic electrophysiology

  • Be able to apply the 10 ECG electrodes correctly

  • Understand the derivation of the 12 leads of a standard 12-lead ECG

  • Name the components of the P-QRS-T complex and understand what each represents

  • Name the intervals (PR, QRS, QT/QTc) and know (or be able to reference) their normal duration (adults)

  • Name the segments (PR, ST, TP) and what each represents

  • Understand the term ‘supraventricular tachycardia’ and recognise life-threatening SVTs

  • Recognise life-threatening bradycardias

  • Gain an overview of atrioventricular blocks

  • Gain an overview of bundle branch blocks

  • Recognise VT, VF, and obvious OMI

  • Gain a basic understanding of the cardiac axis

  • Identify normal sinus rhythm

  • Understand the pathophysiology of angina: stable, unstable and Prinzmetal

  • Recognise myocardial infarct patterns: TWI, ST changes, RW progression and pathological Q waves


One day (six hours)

Certification / accreditation / endorsement

Certified by PREMED. CPD certificate upon completion of the course.


Canterbury, Kent.


Please note: PhEDECs™ does not qualify the learner to provide interventions

outside the scope of practice set by their employer and/or regulatory body. 


Ryan Murray

Ambulance paramedic

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