EMS 12-Lead

APRIL 8, 2022

1] Here is the admitting ED ECG after cancellation of Code STEMI. The patient continued to verbalize cessation of symptoms while in the ED. However, in this context (i.e. cessation of symptoms), and in this unique territory (V2-V4), the T-wave characteristics are consistent with posterior reperfusion! [1] 1] Driver, B.

STEMI 130

STEMI ALS Coronary CAD 130

EMDocs

FEBRUARY 12, 2024

As the only respiratory therapist in the ED has been paged and is starting BiPAP for this patient, an overhead call for two incoming trauma alerts from a multivehicle collision sounds. Because the RT responsible for drawing arterial blood gases is busy caring for these patients, ABGs will be delayed.

Emergency Department 94

Emergency Department E-9-1-1 ED ICU 94

Dr. Smith's ECG Blog

JULY 27, 2023

On arrival to the ED, the patient was diaphoretic, tachycardic. I did not think it was due to ACS, but we ordered an ED ECG immediately: What do you think? He had a prehospital ECG that was worrisome to the medics, so they called me to see him at the door. and had dilated pupils. He was alert and oriented. both here and here ).

Coronary 52

Coronary ACS Naloxone Plasma 52

EMDocs

OCTOBER 21, 2023

The NIHSS cutoff that predicts outcomes is 4 points higher in AC compared with PC infarctions. Median time from ED arrival to diagnosis was 8 hours 24 min in one study, with only 19% being diagnosed within the 4.5-hour doi: 10.1136/neurintsurg-2016-012515. Epub 2016 Jul 15. Post TW, ed. hour IV thrombolytic window.

EMS 74

EMS ALS OR ACS 74

Dr. Smith's ECG Blog

DECEMBER 19, 2023

Because there was proven thrombus (ACS) but the troponin never went above the 99% reference range (and therefore cannot be called MI -- definition of MI requires rise and/or fall of troponin with at least one value above the 99% reference range), this is UNSTABLE ANGINA with ST Elevation. After all, there is no S wave in lead V3.

E-9-1-1 123

E-9-1-1 Coronary ACS BLS 123

Don't Forget the Bubbles

JULY 22, 2024

Pre-school wheezers remain a poorly understood cohort of children despite seeing them every day in paediatric EDs. However, there was no difference in LOS (83 minutes for placebo vs 79 minutes for prednisolone) in participants who were discharged straight from the ED ( 32% ). Compare this with the Panickar et al. study from 200 9.

E-9-1-1 105

E-9-1-1 ALS ACS ED 105

EMDocs

SEPTEMBER 25, 2023

However, RSI has never been shown to reduce the risk of aspiration in the ED (13) or during emergent OR cases (14). While RSI should remain the gold standard in the vast majority of patients in the ED, FI presents an additional technique to mitigate anatomic or physiologic risk. To date, ketamine has been the agent of choice (12).

ED 65

ED Emergency Department ALS OR 65

Dr. Smith's ECG Blog

OCTOBER 3, 2018

For some reason unknown to me, the interventionalist was in the ED. Methods : The PERFECT study (#NCT02765477) is a retrospective, 16 center, international investigation of ED patients from 1/2008 - 12/2016 with VPR on the ECG and symptoms of acute coronary syndrome (ACS). Data from ten sites are presented here.

Coronary 52

Coronary STEMI Paramedic ALS 52

Dr. Smith's ECG Blog

AUGUST 3, 2017

More comments by Smith Isolated precordial ST depression (without ST elevation) in ACS Isolated precordial ST depression (STD) may be due to either subendocardial ischemia (usually V4-V6) or be reciprocal to posterior ST Elevation (maximal STD in V1-V4). July 2016. O'Gara et al. Circulation. J Cardiol 1987 Apr 1;59(8):782-7.

STEMI 52

STEMI E-9-1-1 Coronary ALS 52

EMDocs

JANUARY 6, 2024

A 64-year-old male presents by EMS to the ED with shortness of breath. Answer : Cardiac Transplant Complications Epidemiology: There were over 3,000 heart transplants in North America in 2016. 2 Anatomy and Physiology: There are a few key anatomical differences in our heart transplant patients that ED clinicians must be aware of.

EMS 63

EMS E-9-1-1 ACS Coronary 63

EMS 12-Lead

APRIL 2, 2022

Anecdotally, had there been symptoms unequivocally consistent with ACS then one could justifiably make the case for a potential D1 occlusion. Chou’s Electrocardiography in Clinical Practice, 6th ed. Goldberger’s Clinical Electrocardiography: A Simplified Approach, 9th ed. Annals of Noninvasive Electrocardiology, 18 (1), 21-28.

ALS 130

ALS STEMI Coronary OR 130

Don't Forget the Bubbles

JUNE 30, 2023

All you know, back in ED, is that the ETA is 10 minutes, and there is a single stab wound to the chest. The ODP is caught up leaving theatres and has not yet made it down to ED. A recent review was conducted on Trauma Quality Improvement Program data between 2014 and 2016. Back in ED with Ranulf, and pack two has gone through.

E-9-1-1 139

E-9-1-1 FFP Plasma Emergency Department 139

REBEL EM

FEBRUARY 2, 2023

Background Information: Atrial fibrillation with rapid ventricular rate (RVR) is one of the many tachydysrhythmias we encounter in the Emergency Department (ED). The average time to control HR in the IV amiodarone was 1.7h, which is usually the average time for disposition from the ED. Paper: Mason JM, et al.

Emergency Department 52

Emergency Department ALS Critical Care ED 52

ACEP Now

NOVEMBER 7, 2023

A 67-year-old man presents to the emergency department (ED) in cardiac arrest. On ED presentation, he is unresponsive and the monitor shows ventricular fibrillation. Emmerson AC, Whitbread M, Fothergill RT. He was found by bystanders after he collapsed and 911 was called. Canadian Journal of Emergency Medicine. 20(S1):S67.

Defibrillator 52

Defibrillator E-9-1-1 ALS Epinephrine 52

AAEM RSA

APRIL 1, 2021

1 The American College of Surgeons’ (ACS) Trauma Quality Improvement Program (TQIP) Massive Transfusion in Trauma Guidelines leave a good amount of flexibility for hospitals regarding transfusion protocols, focusing more on systems-level aspects of designing and implementing MTPs.2,3 ACS TQIP Best Practice Guidelines. 248(3):447-58.

E-9-1-1 52

E-9-1-1 Plasma ACS ALS 52

REBEL EM

JULY 14, 2022

Epub 2016 Jun 28. PMID: 30060961 Koller AC, et al. Admission of out-of-hospital cardiac arrest victims to a high volume cardiac arrest center is linked to improved outcome. Resuscitation. PMID: 27368428 Elmer J, et al. Long-Term Outcomes of Out-of-Hospital Cardiac Arrest Care at Regionalized Centers. Ann Emerg Med. Epub 2018 Jul 4.

ICU 52

ICU ALS OR CPR 52

Dr. Smith's ECG Blog

APRIL 8, 2015

Summary of ED Approach to Syncope Please excuse the formatting problems, which I have not been able to fix! Finally, much of this correlates well with The new Canadian Syncope Arrhythmia Risk Score , just published in 2016, results of which are given below in the Annotated Bibliography. ED diagnosis of vasovagal syncope (-1) 8.

Emergency Department 52

Emergency Department E-9-1-1 ED OR 52