Dr. Smith's ECG Blog

JULY 21, 2024

He required multiple defibrillations within a period of a few hours. This time, the arrhythmia did not spontaneously terminate — but rather degenerated to VFib, requiring defibrillation. Some episodes of PMVT would terminate spontaneously — but on many occasions, the PMVT degenerated to VFib, requiring defibrillation.

Defibrillator 113

Defibrillator Coronary ALS STEMI 113

Dr. Smith's ECG Blog

JULY 14, 2023

He underwent further standard resuscitation EXCEPT that we applied the Inspiratory Threshold Device ( ResQPod ) AND applied Dual Sequential Defibrillation (this simply means we applied 2 sets of pads, had 2 defib machines, and defibrillated with both with only a fraction of one second separating each defibrillation.

E-9-1-1 89

E-9-1-1 Defibrillator CPR STEMI 89

Dr. Smith's ECG Blog

JUNE 14, 2024

But artifact is "alive and well" — and learning to recognize it will amaze many of your colleagues ( and may serve to avoid an unnecessary defibrillation or two ). The November 10, 2020 post — for PTA. The October 17, 2020 post — for a 70-year old woman with " Artifactual VT ". Here is an example of that.

Defibrillator 77

Defibrillator ALS Coronary OR 77

Dr. Smith's ECG Blog

SEPTEMBER 16, 2024

After resuscitation and defibrillation , there were no more episodes of TdP. Below is the patient’s 12 lead ECG following defibrillation. There are no clear signs of OMI. The patient was admitted and put telemetry. While on telemetry monitoring he suffered cardiac arrest and was resuscitated. There is a prolonged QTc. There a two PVCs.

Defibrillator 68

Defibrillator Coronary OR ALS 68

NAEMSP

APRIL 19, 2023

CPR is taken over by responding crews, and he is placed on a cardiac monitor/defibrillator. After several cycles of defibrillation, epinephrine, and amiodarone, the patient remains in cardiac arrest. 2020) thus lending itself to a potential drug for cardiac arrest. He is found to be in ventricular fibrillation (VF).

E-9-1-1 52

E-9-1-1 Advanced Life Support Overdose CPR 52

NCOAE

AUGUST 12, 2022

20, 2020: Surfing Terminology and Slang: You Can’t Play BINGO Without the Lingo From Oct. 10, 2020: On Belay — Climbing Terminology and Slang From Oct. If you recall, we started out with some “gnarly” surfing terms, then we “tied in” to a conversation about climbing, finally pulling a “wet exit” on the language of paddling.

EMS 52

EMS EMT EMT Emergency Medical Technician 52

EMDocs

NOVEMBER 19, 2024

Second-generation antipsychotics (see Table 1 below) improve both positive and negative symptoms of schizophrenia and are less likely to be associated with EPS. 1,2 Most second-generation antipsychotics act as D 2 antagonists and inhibit the 5-HT 2A receptor. Atypical antipsychotics come in daily and long-acting forms.

Overdose 77

Overdose EMS Emergency Medical Services OR 77

Dr. Smith's ECG Blog

SEPTEMBER 2, 2024

This episode self terminated before defibrillation was possible. That said — in a patient who develops TdP — the overall ECG appearance of this initial ECG is consistent with low K+ and/or low Mg++ ( See My Comment in the May 9, 2020 post — for more on the ECG diagnosis of hypokalemia and hypomagnesemia ).

E-9-1-1 104

E-9-1-1 ALS Defibrillator OR 104

Dr. Smith's ECG Blog

SEPTEMBER 12, 2023

For more on my systematic approach — Check out My Comment in the May 3, 2020 post ). For more on my systematic approach — Check out My Comment in the May 3, 2020 post ). Treatment is by ICD ( implantable cardioverter defibrillator ). How Short is the QTc in Today's Tracing? 1 for a rate ~75/min; 1. 2 for ~85/min; and 1.

Defibrillator 69

Defibrillator OR 69

Dr. Smith's ECG Blog

OCTOBER 23, 2023

She was successfully revived after several rounds of ACLS including defibrillation and amiodarone. By EMS report, open pill bottles were found nearby at the scene, including quetiapine, fluoxetine, hydroxyzine, and gabapentin. On arrival to the ED the patient was intubated with normal vital signs.

ICU 120

ICU OR Defibrillator EMS 120

Dr. Smith's ECG Blog

JANUARY 23, 2024

She was given CRT-D (Cardiac Resynchronization Therapy-Defibrillator). For the majority of the tracing there are two P waves for each QRS. There is a LBBB. The PR interval gradually prolongs until a QRS is dropped and the pattern repeats itself. If there is no BBB the QRS will be narrow. There is for the most part 2:1 AV block.

Coronary 85

Coronary OR Defibrillator ALS 85

Dr. Smith's ECG Blog

JANUARY 15, 2024

They had difficulty describing their symptoms, but complained of severe weakness, nausea, vomiting, headache, and chest pain. They denied fever, cough, dyspnea, and sick contacts. They described the chest pain as severe, crushing, and non-radiating. It was not worse with exertion or relieved by rest. The case continues.

Critical Care 64

Critical Care Defibrillator OR ALS 64

EMT Training Station

FEBRUARY 11, 2024

We use portable electrocardiogram (ECG) machines to monitor heart rhythms and are equipped to administer life-saving interventions like defibrillation or medication administration to stabilize the heart rhythm. The entry and exit wounds are key indicators, but they can be small or hidden under clothing.

EMT 98

EMT EMT Emergency Medical Technician First Aid 98

REBEL EM

DECEMBER 19, 2022

Background Information: Double external defibrillation (DED) is an intervention often used to treat refractory ventricular fibrillation (RVF). This procedure involves applying another set of pads attached to a second defibrillator to a patient and shocking them in hopes of terminating the rhythm. N Engl J Med.

Defibrillator 52

Defibrillator Paramedic CPR EMS 52

Dr. Smith's ECG Blog

SEPTEMBER 21, 2020

He was found in ventricular fibrillation and defibrillated, then brought to a local ED which does not have a cath lab. I’ve previously discussed clinical application of the Mirror Test on several occasions ( SEE My Comment at the bottom of the page in both the September 13, 2020 post and the February 16, 2019 post in Dr. Smith’s ECG Blog ).

STEMI 52

STEMI Defibrillator ED ACS 52

Dr. Smith's ECG Blog

FEBRUARY 13, 2023

Int J Cardiol Heart Vasc 2020 3. This is obvious STEMI(+)OMI of proximal LAD. This case illustrates three common pitfalls of the STEMI paradigm, which can be improved by OMI ECG findings: 1. STEMI on serial ECG, or OMI from the start? According to the STEMI paradigm, ECG #1 is nondiagnostic whereas ECG #2 is STEMI. Non-STEMI or STEMI(-)OMI?

STEMI 52

STEMI Paramedic Coronary ALS 52

Dr. Smith's ECG Blog

APRIL 29, 2020

She was never defibrillated. 3 of the 4 have similarly bizarre PVCs. == MY Comment by K EN G RAUER, MD ( 4/29/2020 ): == Cardiac Arrest with Bizarre PVCs/Torsades de Pointes: Intriguing case with many interesting features. As was seen in this case — defibrillation and/or overdrive pacing may be needed. What do you think?

Defibrillator 52

Defibrillator Epinephrine Coronary Overdose 52

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'

STEMI 52

STEMI Defibrillator OR ALS 52

Paramedic Training Spot

NOVEMBER 29, 2021

Learning how to become an EMT in New Jersey, or an Emergency Medical Technician to be specific, is not an overnight accomplishment. Not only are you training to be a Garden State EMT, you are studying to become Nationally Registered, which is a relatively new requirement for the state.

EMT 52

EMT EMT EMR Emergency Medical Technician 52

Dr. Smith's ECG Blog

OCTOBER 26, 2020

12 minutes later, the patient went back into VFib arrest and underwent another 15 minutes of resuscitation followed by successful defibrillation and sustained ROSC. In total, he received approximately 40 minutes of CPR and 7 defibrillation attempts. EMS found the patient in VFib and performed ACLS for 26 minutes then obtained ROSC.

Coronary 52

Coronary Defibrillator ACS CAD 52

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).

E-9-1-1 52

E-9-1-1 CAD STEMI OR 52

Dr. Smith's ECG Blog

NOVEMBER 30, 2022

She was defibrillated and resuscitated. V1 has 0.5 mm of ST segment elevation, V2 and V3 have 1 mm of elevation, v4 has 2 mm of elevation and v5 around 1.5 mm of elevation. More notably there are hyperacute T waves in V3 through V5. There is also T wave inversion In aVL with a very small amount of ST segment depression. Learning Points: 1.

Emergency Department 52

Emergency Department E-9-1-1 Coronary STEMI 52

EMDocs

JANUARY 3, 2024

1 Like other implantable devices, such as pacemakers and automated implantable cardioverter defibrillators (AICDs), they can be interrogated for valuable information by the patient ’ s cardiology team when the patient presents to the ED. Optivol TM , measures thoracic impedance through an ICD or CRT-D device. arrhythmia).

Defibrillator 86

Defibrillator Allergic Reaction ED ALS 86

Dr. Smith's ECG Blog

FEBRUARY 17, 2023

Treatment is by ICD ( implantable cardioverter defibrillator ). The disorder is rare — but it takes on importance as a potential cause of atrial and ventricular arrhythmias, including cardiac arrest. Males with a QTc ≤330 ms — and females with a QTc ≤340 ms are defined as having SQTS , even if they are asymptomatic.

STEMI 52

STEMI Defibrillator OR ED 52