Dr. Smith's ECG Blog

OCTOBER 28, 2013

It was witnessed, and CPR was performed by trained individuals. She arrived in the ED 37 minutes after 911 was called, with continuing CPR. Here is an article I wrote: Updates on the ECG in ACS. Was this: 1) ACS with ischemia and spontaneous reperfusion? The following 12-lead ECG was recorded at 11 minutes after ROSC.

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Dr. Smith's ECG Blog

OCTOBER 24, 2013

He underwent immediate CPR, was found to be in ventricular fibrillation, and was successfully resuscitated. Therefore, even with a normal or non-diagnostic ECG, a 50 year old male patient should undergo serial ECGs and troponins and be admitted to a monitored bed until MI or ACS can be ruled out. See explanation below.

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Dr. Smith's ECG Blog

OCTOBER 10, 2022

CPR was initiated immediately. If this is ACS with Aslanger's pattern , the ST depression vector of subendocardial ischemia (due to simultaneous 3 vessel or left main ACS) is directed toward lead II (inferior and lateral). It was reportedly a PEA arrest; there was no recorded V Fib and no defibrillation.

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Don't Forget the Bubbles

MAY 3, 2023

Reviewed by: Roberto Segura and Mel Ranaweera Article 3: Does hand position affect CPR quality in young children? The effect of hand position on chest compression quality during CPR in young children: Findings from the Videography in Pediatric Resuscitation (VIPER) collaborative. Garabon JJW, Gunz AC, Ali A, Lim R.

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Dr. Smith's ECG Blog

MARCH 9, 2017

CPR was initiated and she subsequently entered into V-Fib storm. ACS can be a very dynamic process. Another ECG is obtained: She suddenly occluded her LAD with a very large territory of viable myocardium at risk! Shortly after this ECG she suddenly went unresponsive and into V-Fib.

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Dr. Smith's ECG Blog

AUGUST 9, 2019

But if they do present: The very common presentation of diffuse STD with reciprocal STE in aVR is NOT left main occlusion , though it might be due to sub total LM ACS, but is much more often due to non-ACS conditions, especially demand ischemia. They will add up in varying magnitudes resulting in a variety of ECG presentations.

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Dr. Smith's ECG Blog

SEPTEMBER 16, 2015

It is highly associated with proximal LAD occlusion or severe left main ACS and with bad outcomes. Here you can see abnormal (diagnostic) ST elevation and an upright T-wave in V2-V3, with diagnostic ST elevation in V4-V6 and in I and aVL, and with reciprocal ST depression in III and aVF. So this is diagnostic of proximal LAD occlusion.

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EMT Training Station

FEBRUARY 11, 2024

Assessing the Severity The severity of an electrical burn depends on several factors: the type of current (AC or DC), voltage, the pathway of the current through the body, the duration of contact, and the victim’s overall health. If the victim is unresponsive, CPR is initiated immediately.

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Dr. Smith's ECG Blog

OCTOBER 20, 2013

Medics found her apneic and pulseless, began CPR, and she was found to be in asystole. A middle-age woman with h/o hypertension was found down by her husband. With ventilations and epinephrine, she regained a pulse. She was never seen to be in ventricular fibrillation and was never defibrillated.

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ACEP Now

NOVEMBER 7, 2023

1 Overall, survival is poor following cardiac arrest, and is affected by factors including age, comorbidities, witnessed arrest, early CPR, early defibrillation, and return of spontaneous circulation (ROSC). Emmerson AC, Whitbread M, Fothergill RT. Canadian Journal of Emergency Medicine. 20(S1):S67. Resuscitation. 2017;117:97-101.

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EMDocs

JANUARY 11, 2024

Data that do not establish neurological risk stratification in the first 6 hours after CA include the patient’s age, duration of CPR, seizure activity, serum lactate level or pH, Glasgow motor subscore in patients who received NMB or sedation, pupillary function in patients who received atropine, and optic nerve sheath diameter (95.3%, 20/21).

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ACEP Now

OCTOBER 11, 2024

Optimally, bystander CPR, including the administration of rescue breaths, should be initiated prior to arrival of emergency medical services. References Webb AC, Wheeler A, Ricci A, et al. Every effort should be made to restore adequate oxygenation, ventilation, and perfusion as soon as possible. South Med J. 2021;114(5):266-270.

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Dr. Smith's ECG Blog

NOVEMBER 23, 2022

He underwent CPR and then was shocked out of VF. ST depression maximal in V1-V4, in the context of ACS symptoms and unexplained by QRS abnormality or tachydysrhythmia, should be considered posterior OMI until proven otherwise. His initial troponin T was 15 ng/L (only two hours since pain onset).

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Dr. Smith's ECG Blog

OCTOBER 26, 2020

In total, he received approximately 40 minutes of CPR and 7 defibrillation attempts. Learning Points: The myocardium doesn't know the etiology of OMI (ACS, spasm, dissection, embolus, etc.), That said, ACS is by far the most common and treatable cause.

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REBEL EM

JULY 14, 2022

PMID: 30060961 Koller AC, et al. I would rather use a PCAC score to decide on transfer than arrest characteristic (time of CPR, initial rhythm, etc) because we know that all of that data is prone to bias as well. Epub 2016 Jun 28. PMID: 27368428 Elmer J, et al. Ann Emerg Med. Epub 2018 Jul 4. Resuscitation.

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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. of Cardiology AC, Others. A Rising Troponin That afternoon, he complained of increased shortness of breath and was noted to have oxygen saturations in the 70s, prompting a mini code to be called.

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Dr. Smith's ECG Blog

MARCH 8, 2025

Angiography was technically challenging as the patient was receiving CPR, but the cardiologist suspected acute stent thrombosis and initiated cangrelor, although no repeat angiography was able to be obtained. After completing the ACS algorithm with amiodarone and lidocaine, there are diminishing returns on further treatments.

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