Dr. Smith's ECG Blog

OCTOBER 28, 2013

Fine ventricular fibrillation She received 2 mg epinephrine, 150 mg amiodarone and underwent chest compressions with the LUCAS device. Here is an article I wrote: Updates on the ECG in ACS. Was this: 1) ACS with ischemia and spontaneous reperfusion? She arrived in the ED 37 minutes after 911 was called, with continuing CPR.

Defibrillator 52

Defibrillator ACS CPR STEMI 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.

E-9-1-1 52

E-9-1-1 ALS Coronary Epinephrine 52

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.

STEMI 52

STEMI ACS Coronary Defibrillator 52

Dr. Smith's ECG Blog

OCTOBER 20, 2013

With ventilations and epinephrine, she regained a pulse. Kurkciyan et al. Kurkciyan et al., A middle-age woman with h/o hypertension was found down by her husband. Medics found her apneic and pulseless, began CPR, and she was found to be in asystole. She was hypotensive in the ED and her bedside echo showed a normal RV and LV.

STEMI 52

STEMI Coronary ACS Emergency Department 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.

E-9-1-1 52

E-9-1-1 ALS Emergency Department Epinephrine 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 40

Coronary ACS ALS STEMI 40

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