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? I was not worried for a coronary etiology. 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.

Coronary 52

Coronary ACS Naloxone Plasma 52

ACEP Now

MARCH 14, 2024

A 44 year-old male with unknown past medical history came by emergency medical services (EMS) to the emergency department (ED) for an electrical injury and fall from a high voltage electrical pole. McGraw Hill; 2016. Acute myocardial infarction with normal and near normal coronary arteries. In: StatPearls [Internet].

Operating Room 52

Operating Room ACS Critical Care Coronary 52

REBEL EM

FEBRUARY 22, 2023

et al, Emergency Medicine Clinical Essentials ed 2. Eye Emergencies, in Tintinalli J et al (eds): Tintinalli’s Emergency Medicine: A Comprehensive Study Guide, Seventh Edition New York City: McGraw-Hill 2016 (Ch) 241 Guluma K, Lee JE. Philadelphia: Elsevier, 2013 (Ch) 26: p. 209-225 Walker R, Adhikari S.:

Emergency Department 52

Emergency Department ALS ED Coronary 52

EMDocs

OCTOBER 21, 2023

A 68-year-old male with a past medical history of hypertension, diabetes mellitus, and coronary artery disease with a drug eluting stent placed 2 months ago presents with dizziness and vomiting that began 3 hours ago. 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

EMS 74

EMS ALS OR ACS 74

Dr. Smith's ECG Blog

OCTOBER 3, 2018

When he showed it to me, I said "Ouch, looks like an acute coronary occlusion. For some reason unknown to me, the interventionalist was in the ED. no LBBB or paced rhythm), acute coronary occlusion MI (OMI) is diagnosed in approximately 75% of cases. What happened?" On arrival, the patient went into ventricular fibrillation.

Coronary 52

Coronary STEMI Paramedic ALS 52

Dr. Smith's ECG Blog

AUGUST 3, 2017

It is our job to identify this entity and ensure these patients receive the same care they would for a STEMI in any other coronary artery territory. Therein lies the limitation of electrocardiography in diagnosing acute coronary occlusion. Tips for recognizing Acute Posterior STEMI: 1. Neth Heart J. 2007; 15: 16-21. Wung SF, Drew BJ.

STEMI 52

STEMI E-9-1-1 Coronary ALS 52

Dr. Smith's ECG Blog

JUNE 2, 2023

Despite otherwise normal vital signs, she was appropriately triaged to the critical care area of the ED. They are rare and hard to find in normal practice in the ED. She denied chest pain and denied feeling any palpitations, even during her triage ECG: What do you think? In contrast — a broader passband ( typically from 0.05

ED 78

ED OR ALS CAD 78

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

Don't Forget the Bubbles

AUGUST 21, 2023

“Hi, phoning from ED with a referral. The ED team helpfully did a gas while you headed down to review, and as you scan the numbers, you see that the baby has a severe mixed respiratory/lactic acidosis. European Journal of Pediatrics; 2016: 175; 1461-1462 Cox, GF. In: Nichols, DG and Shaffner, DH (eds.) 34; 963 – 969.

ALS 98

ALS Critical Care ED OR 98

EMS 12-Lead

APRIL 2, 2022

He reported a history of ischemic cardiomyopathy with coronary stent placement approximately 10 years prior, but could not recall the specific artery involved. Chou’s Electrocardiography in Clinical Practice, 6th ed. Goldberger’s Clinical Electrocardiography: A Simplified Approach, 9th ed. Attached is the first ECG.

ALS 130

ALS STEMI Coronary OR 130

Dr. Smith's ECG Blog

FEBRUARY 4, 2023

Pretest probability: Especially when there is no Chest pain, or there are very atypical symptoms, one should be very suspicious of the diagnosis of coronary occlusion unless the ECG is crystal clear. Look for old ECGs Do serial ECGs Do echocardiography June 17, 2016 Anterior STEMI?

STEMI 52

STEMI Coronary EMS ED 52

EMDocs

OCTOBER 30, 2023

” – Musings of an American ED resident in July 2022 when US healthcare was affected simultaneously by supply chain issues from GE Healthcare (contrast media) and Abbott Laboratories (Similac baby formula). 3 A study of CT use trends in the ED has shown increasing use of CTs by almost 60% from 2005 to 2013.

E-9-1-1 73

E-9-1-1 Emergency Department ALS ED 73

Dr. Smith's ECG Blog

JULY 22, 2023

An ECG was performed in the ED at 1554: Original image unavailable, this is the only recorded scanned ECG available. QOH Interpretation: The initial troponin I (older generation) at the first ED was barely positive at 0.06 He denied chest pain or shortness of breath. See below for PM Cardio digitized version of this.

E-9-1-1 70

E-9-1-1 CAD OR STEMI 70

Dr. Smith's ECG Blog

JUNE 17, 2016

Pretest probability: Especially when there is no Chest pain, or there are very atypical symptoms, one should be very suspicious of the diagnosis of coronary occlusion unless the ECG is crystal clear. The diagnostic problem posed in today's repost from June 17, 2016 is a perfect example of this.

STEMI 52

STEMI OR Coronary EMS 52

Dr. Smith's ECG Blog

MAY 13, 2017

Here is a one hour lecture on the topic of subtle coronary occlusion, especially on the left anterior descending coronary artery. A thin, athletic young African American male presented by private transportation to the ED after use of "ecstasy" and alcohol and other drugs. JAMA Internal Med 2016 Dec 1.; 176(12)1875-1876.]

STEMI 52

STEMI Coronary OR ED 52

Core EM

DECEMBER 12, 2023

Promoting Reproductive Health in the ED In the post Roe v. Emergency medicine providers should be familiar and comfortable with prescribing both long-term and emergency contraception in the ED, ultimately reducing the burden of unintended pregnancy and its subsequent disparities on vulnerable patient populations. 2016 Oct;21(5):347-55.

Emergency Department 130

Emergency Department OR ALS Coronary 130

EMDocs

NOVEMBER 13, 2023

The use of CTA (computed tomography angiography) in the emergency department (ED) has increased dramatically in the past 20 years. of all patients in the ED for over 800 different stated indications. 5, 6 Further, any use of imaging prolongs ED stays, which by extension increases ED wait times for other patients.

E-9-1-1 87

E-9-1-1 ALS Emergency Department ED 87

Don't Forget the Bubbles

DECEMBER 5, 2023

This paper retrospectively assembled a cohort of patients diagnosed with UC between 1998 and 2016 and aged between 10 and 24. Sex ed” sucks. They believe that Sex Ed programs are irrelevant to real-life experience and contain inadequate discussion of important issues, including consent or positive sexual relationships.

Coronary 111

Coronary Epinephrine CPR Emergency Department 111

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