Dr. Smith's ECG Blog

JUNE 19, 2023

Armstrong et al. The patient is started on epinephrine infusion for cardiogenic shock and cardiology took the patient to the cath lab. ST depression maximal in V1-V4, without a QRS abnormality clearly causing it, in the setting of ACS symptoms, is very concerning for posterior MI until proven otherwise.

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STEMI ACS Coronary Defibrillator 52

ECG & Echo Learning

OCTOBER 2, 2022

Epinephrine Shock (any) Cardiac arrest Bronchospasm Anaphylaxis Bradycardia (second-line alternative) Infusion : 0.01 References Overgaard, Dzavik et al. Jentzer et al. Müllner M, Urbanek B, Havel C, et al. Lherm T, Troché G, Rossignol M, et al. Gattinoni L, Brazzi L, Pelosi P, et al. Circulation 2011.

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E-9-1-1 ALS Coronary Epinephrine 52

ACEP Now

NOVEMBER 14, 2023

References Deshwal H, Sinha A, Mehta AC. Atchinson PRA, Hatton CJ, Roginski MA, et al. Ittrich H, Bockhorn M, Klose H, et al. Li H, Ding X, Zhai S, et al. Kathuria H, Hollingsworth HM, Vilvendhan R, et al. Fekri MS, Hashemi-Bajgani SM, Shafahi A, et al. Wand O, Guber E, Guber A, et al. Am J Emerg Med.

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

FOAMfrat

OCTOBER 20, 2023

And according to a paper from Russotto et al. Of note, in the paper by Russotto et al., Epinephrine should be considered as the vasopressor of choice in patients with decreased myocardial function. Sackles et al. Heffner AC, Swords DS, Neale MN, Jones AE. De Jong A, Molinari N, Terzi, et al. Brown, C.A.

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E-9-1-1 ALS ACS OR 52

Dr. Smith's ECG Blog

NOVEMBER 19, 2016

Although this is considered a "STEMI equivalent" and the ACC/AHA guidelines even approve of thrombolytics for ACS with this ECG, the usual criteria used to alert the cath lab team of an inbound Code STEMI are not met by this ECG. For instance: sepsis, bleeding, dehydration, hypoxia, and mild ACS. NEJM 362(9):779; March 4, 2009.

Coronary 52

Coronary ACS ALS STEMI 52

Dr. Smith's ECG Blog

NOVEMBER 12, 2020

He underwent CPR, and regained a pulse after epinephrine, with an organized narrow complex rhythm at 140, but still with severe shock. 3–8 Shi et al. Sandoval Y, Smith SW, Sexter A, et al. Shi S, Qin M, Shen B, et al. Guo T, Fan Y, Chen M, et al. Lala A, Johnson KW, Russak AJ, et al.

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E-9-1-1 STEMI Coronary ALS 52

ACEP Now

NOVEMBER 7, 2023

Multiple attempts at defibrillation, epinephrine, and amiodarone have been unsuccessful. References Go AS, Mozaffarian D, Roger VL, et al. Larribau R, Deham H, Niquille M, et al. Margey R, Browne L, Murphy E, et al. Kudenchuk PJ, Brown SP, Daya M, et al. Spies DM, Kiekenap J, Rupp D, et al. Circulation.

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Defibrillator E-9-1-1 ALS Epinephrine 52