Dr. Smith's ECG Blog

NOVEMBER 30, 2022

This case was provided by Spencer Schwartz, an outstanding paramedic at Hennepin EMS who is on Hennepin EMS's specialized "P3" team, a team that receives extra training in advanced procedures such as RSI, thoracostomy, vasopressors, and prehospital ultrasound. Reference on Troponins: Xenogiannis I, Vemmou E, Nikolakopoulos I, et al.

Emergency Department 52

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

Dr. Smith's ECG Blog

NOVEMBER 2, 2015

Serial ECGs demonstrated dynamic changes diagnostic of ACS (transient STEMI) 4. Even after STEMI (if reperfused, with small amount of myocardium infarcted), and even when the ECG is diagnostic of ACS (as it was the next day), the simultaneous echocardiogram may be normal. Learning Points 1. This was diagnosed as a NonSTEMI. Hypothesis.

Paramedic 52

Paramedic STEMI ACS Ambulance 52

EMS 12-Lead

APRIL 8, 2022

David Didlake Firefighter / Paramedic Acute Care Nurse Practitioner @DidlakeDW Peer review by Dr. Stephen Smith @smithECGblog I was reviewing ECG’s in our LifeNet database and happened upon this one without any knowledge of clinical circumstances. 1] Driver, B. Posterior wall reperfusion T-waves: Wellens’ syndrome of the posterior wall.

STEMI 130

STEMI ALS Coronary CAD 130

EMS 12-Lead

JUNE 1, 2022

David Didlake Firefighter / Paramedic Acute Care Nurse Practitioner @DidlakeDW Peer review provided by Dr. Steve Smith [link] @SmithECGblog A 72 y/o Male experiences a syncopal episode while seated. This is important because we must rely on the ECG to further elucidate the story when the patient cannot. 3] Meyers, H. 4] Dodd, K. 5] Isnard, R.

Coronary 130

Coronary ALS ED ACS 130

Dr. Smith's ECG Blog

JUNE 8, 2023

Here’s the paramedic ECG (digitized by PMcardio). According to the STEMI paradigm, the patient doesn’t have an acute coronary occlusion and doesn't need emergent reperfusion, so the paramedics can bring them to the ED for assessment, without involving cardiologists. paramedic transportation to the ED as “chest pain, STEMI negative” 2.

STEMI 85

STEMI Coronary Paramedic ALS 85

EMDocs

SEPTEMBER 25, 2023

Medications: FI has a long history of use in the prehospital world, as many agencies were/are reluctant to provide paralytics to paramedics. References: Heffner AC et al. PMID: 23911630 Kim WY et al. PMID: 23911630 Kim WY et al. PMID: 25402500 Forsythe SM et al. PMID: 10631227 Mosier JM et al.

ED 91

ED Emergency Department ALS Paramedic 91

Don't Forget the Bubbles

JUNE 30, 2023

T – He’s got a single grey cannula in situ, and we’ve given him a 5 mg bolus of IiV morphine on the way in The primary survey Thanking the paramedic team, you ask the T&O SHO to proceed with a primary survey. Kulvatunyou N, Bauman ZM, Zein Edine SB, de Moya M, Krause C, Mukherjee K, Gries L, Tang AL, Joseph B, Rhee P.

E-9-1-1 139

E-9-1-1 FFP Plasma Emergency Department 139

Dr. Smith's ECG Blog

OCTOBER 3, 2018

This was shown to me by a very astute Hennepin paramedic. Although this comes from a Hennepin paramedic, the patient was not brought to Hennepin County Medical Center. It is important for cardiologists to realize that a paramedic may see something they do not. Khan AR, Golwala H, Tripathi A, et al. of this post.

Coronary 52

Coronary STEMI Paramedic ALS 52

Dr. Smith's ECG Blog

MARCH 3, 2025

She was found by paramedics with an oxygen saturation of 64%, but could not tolerate BiPAP during transport due to claustrophobia. This presentation clearly indicates more than simple ACS ( A cute C oronary S yndrome ). She awoke in the morning with sharp chest pain which worsened throughout the morning.

E-9-1-1 73

E-9-1-1 Coronary STEMI Emergency Department 73