Dr. Smith's ECG Blog

JANUARY 27, 2024

, tells us that we physicians do not need to even look at this ECG until the patient is placed in a room because the computer says it is normal: Validity of Computer-interpreted “Normal” and “Otherwise Normal” ECG in Emergency Department Triage Patients I reviewed this article for a different journal and recommended rejection and it was rejected.

STEMI 110

STEMI Coronary ACS ED 110

Dr. Smith's ECG Blog

SEPTEMBER 25, 2024

A 56 year old male with a history of diabetes, dyslipidemia, hypertension, and coronary artery disease presented to the emergency department with sudden onset weakness, fatigue, lethargy, and confusion. The undergraduate is now willing to identify himself: Hans Helseth. No ECG was ordered on Day #1.

Coronary 116

Coronary STEMI Emergency Department OR 116

Dr. Smith's ECG Blog

JUNE 11, 2024

Many systems now refrain from showing computer "normal" ECGs to the busy emergency physicians at triage because of very poorly conceived articles that say that if the computer algorithm says "normal," the emergency physician should not be bothered. It is clearly missed by the conventional algorithm.

STEMI 116

STEMI Coronary Emergency Department OR 116

Dr. Smith's ECG Blog

JANUARY 9, 2024

She presented to the emergency department after a couple of days of chest discomfort. The patient is an older woman with known coronary disease and an ICD-Pacemaker implanted because of a history of VT ( V entricular T achycardia ). The last echocardiography 12 months ago showed HFmrEF. The ECG below was recorded.

Coronary 107

Coronary ACS ED OR 107

EMDocs

MARCH 25, 2024

2, 3 Biliary POCUS can help decrease patient length of stay in the Emergency Department. Video 3: Coronary approach to the gallbladder POCUS Findings Sonographically, the gallbladder is situated in the right upper quadrant as an elongated pear-shaped organ on the inferior surface of the liver. J Educ Teach Emerg Med.

ALS 87

ALS Coronary Emergency Department ED 87

Dr. Smith's ECG Blog

AUGUST 9, 2024

Written by Colin Jenkins and Nhu-Nguyen Le with edits by Willy Frick and by Smith A 46-year-old male presented to the emergency department with 2 days of heavy substernal chest pain and nausea. Serial ECGs enhance the diagnosis of acute coronary syndrome. Annals of Emergency Medicine , 31 (1), 3–11. link] Fesmire, F.

STEMI 92

STEMI Coronary Heart Attack ACS 92

Dr. Smith's ECG Blog

DECEMBER 16, 2024

Cardiology wanted a CT of the aorta to rule out dissection, presumably partly due to the very high blood pressure readings, but also because it is hard for people to believe that a 20-something woman could have acute thrombotic coronary artery. Coronary malperfusion due to type A aortic dissection: mechanism and surgical management.

STEMI 65

STEMI Coronary Critical Care ED 65

Dr. Smith's ECG Blog

DECEMBER 20, 2024

Written by Willy Frick with edits by Ken Grauer An older man with a history of non-ischemic HFrEF s/p CRT and mild coronary artery disease presented with chest pain. The following ECG was obtained in the emergency department during active chest pain. He said he had had three episodes of chest pain that day while urinating.

Defibrillator 57

Defibrillator Coronary ALS Emergency Department 57

Don't Forget the Bubbles

NOVEMBER 18, 2024

The other important moment to always think of the heart (sorry, cardiologists, I don’t think about the heart 24/7) is when a collapsed neonate presents to your emergency department, especially if blood pressure is present. This is one of the situations where you must not forget to feel for femoral pulses. L., & Carcillo, J.

OR 59

OR Critical Care Coronary Emergency Department 59

Dr. Smith's ECG Blog

JANUARY 17, 2024

Using the current paradigm, can you tell which patient had an acute coronary occlusion? STEMI vs OMI Now let’s see the rest of the ECG: can you tell which patient has an acute coronary occlusion, and which ECG has hyperacute T waves? Using T wave amplitude, can you tell which ECG has hyperacute T waves? J Electrocardiol 2017 2.

STEMI 108

STEMI Coronary ALS OR 108

Don't Forget the Bubbles

DECEMBER 5, 2023

A very Merry Christmas from the BW team, and all the Best Wishes for 2024! Data was collected at 2 emergency departments in America and included assessment by both clinicians and patients for a total of 31 patients. Wounds are a common presentation to both adult and paediatric emergency departments.

Coronary 111

Coronary Epinephrine CPR Emergency Department 111

ACEP Now

JUNE 14, 2024

And, finally, patients with a history of COPD frequently present to the emergency department with dyspnea. Although dyspnea in this setting likely represents an AECOPD, other emergent differentials must be considered. ECG evaluates for dysrhythmias, acute coronary syndrome, or signs of right heart strain. Ann Emerg Med.

ALS 52

ALS Coronary OR ED 52

EMDocs

NOVEMBER 4, 2024

54 It is vital to consider dangerous epigastric pain mimickers like acute coronary syndrome (ACS), hepatobiliary disease, or pancreatitis. The Treatment of Acute Pain in the Emergency Department: A White Paper Position Statement Prepared for the American Academy of Emergency Medicine. J Emerg Med. Acad Emerg Med.

ED 99

ED E-9-1-1 Emergency Department ALS 99

Dr. Smith's ECG Blog

NOVEMBER 10, 2024

EMS gave aspirin and nitroglycerin, and the patient noted significant improvement on arrival to the Emergency Department. My Comment , by K EN G RAUER, MD ( 11/10 /2024 ): = Think of today's case as a check of your skill in recognizing when to activate the cath lab. Why did the Repeat ECG look Better than ECG #1?

STEMI 86

STEMI OR ED EMS 86