2013 Defibrillator OR 
The Skeptics' Guide to EM
JULY 3, 2021
Paramedics managed to get return of spontaneous circulation after a single defibrillation, but the patient is still comatose on arrival. This is the original Target Temperature Management (TTM) trial by Nielson et al NEJM 2013. The charge nurse turns to you and asks: should I grab the ice packs? This gives a NNT of 4.
Dr. Smith's ECG Blog
OCTOBER 28, 2013
She was found to be in ventricular fibrillation and was defibrillated 8 times without a single, even transient, conversion out of fibrillation. She was immediately intubated during continued compressions, then underwent a 9th defibrillation, which resulted in an organized rhythm at 42 minutes after initial arrest. It was stented.
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EMDocs
JANUARY 16, 2024
The patient received 1 mg of epinephrine IV x2 with conversion of his rhythm to ventricular fibrillation (VF) for which he was defibrillated twice in the field. The patient is moved over to the stretcher and connected to the monitors and defibrillator. What would your next steps be? His point-of-care labs return with a potassium of 3.4
EMDocs
SEPTEMBER 23, 2023
On arrival, vital signs are stable with a HR of 71, BP of 121/71 mmHg, RR of 17 bpm, and SpO2 of 97% on room air. Physical exam reveals a well-appearing female in no acute distress. Cardiac exam is unremarkable with normal S1/S2 without rubs, gallops or murmurs. Neurological exam is also unremarkable. Her presenting EKG is shown below.
Dr. Smith's ECG Blog
OCTOBER 20, 2013
She was never seen to be in ventricular fibrillation and was never defibrillated. She was hypotensive in the ED and her bedside echo showed a normal RV and LV. BP gradually rose. She was completely comatose (GCS = 3) and pupils were midposition and fixed. Kurkciyan et al. In 25 (93%), the initial rhythm was asystole or PEA. Results: Over 8.5
Dr. Smith's ECG Blog
MAY 6, 2019
Cardioversion/defibrillation. It helps a little bit. Only 5-18% of ED patients with chest pain have a myocardial infarction of any kind. Only 1-5% have OMI. Anyone with a baseline Brugada pattern ECG can have esophageal pain, or chest wall pain, and then be thought to be having an MI based upon a false positive ECG. How can this be 'Not MI'
Dr. Smith's ECG Blog
JANUARY 30, 2019
Schick is a PGY3 at the Brown Emergency Medicine Residency in Rhode Island. I remember Allie well from her days in the Research volunteer program at Hennepin. The article is edited by Smith. Title: Is it just hot in here or is it a OMI? See additional image at the bottom of this post. Could this be induced by elevated core temperature? F (rectal).
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