Dr. Smith's ECG Blog

OCTOBER 10, 2022

He reportedly told his family "I think I'm having a heart attack", then they immediately drove him to the ED, and he was able to ambulate into the triage area before he collapsed and became unresponsive. CPR was initiated immediately. It was reportedly a PEA arrest; there was no recorded V Fib and no defibrillation.

ACS 52

ACS CPR CAD Heart Attack 52

Dr. Smith's ECG Blog

MARCH 9, 2017

Case A 42-year-old lady presented to the ED with complaints of intermittent episodes of chest pain associated with shortness of breath for the last 2 days. CPR was initiated and she subsequently entered into V-Fib storm. If this patient was discharged from the ED she very likely would have died. Thanks, Sam! Normal ECG.”

CPR 52

CPR ACS Coronary ED 52

Dr. Smith's ECG Blog

AUGUST 9, 2019

Smith and Meyers answer: First , LM occlusion is uncommon in the ED because most of these die before they can get a 12-lead recorded. Only 28% of patients had ACS of any vessel, and, of those patients, the LM was the culprit in just 49% (14% of all cases).(56) Of those who do get to the ED, many present with clear STE.(65,

Coronary 52

Coronary STEMI ACS ALS 52

ACEP Now

OCTOBER 11, 2024

Optimally, bystander CPR, including the administration of rescue breaths, should be initiated prior to arrival of emergency medical services. ED treatment should focus on airway, breathing, and circulation with consideration for cervical spine protection depending on the circumstances surrounding the event. South Med J. Acad Emerg Med.

ALS 52

ALS Emergency Department Emergency Medical Services ED 52

Dr. Smith's ECG Blog

SEPTEMBER 16, 2015

The patient arrived in the ED and had this ECG recorded: Interpretation? It is highly associated with proximal LAD occlusion or severe left main ACS and with bad outcomes. But the clinical history is not compatible with STEMI, so one must be very cautious about the ECG interpretation. The medics activated the cath lab.

STEMI 40

STEMI CPR CAD Coronary 40

Dr. Smith's ECG Blog

NOVEMBER 23, 2022

About an hour later, he was then found on the floor in cardiac arrest in the ED. 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.

Coronary 52

Coronary Heart Attack ED CPR 52

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.

ICU 52

ICU ALS OR CPR 52

Dr. Smith's ECG Blog

NOVEMBER 12, 2020

This is a 30-something healthy patient presented with COVID pneumonia who presented to the ED. 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. He was moderately hypoxic. He was intubated and then went pulseless.

E-9-1-1 52

E-9-1-1 STEMI Coronary ALS 52

Don't Forget the Bubbles

MAY 3, 2023

This single-centre academic urban institution in the United States (US) undertook a 10-year retrospective observational study of paediatric intubation and bougie use in their emergency department (ED). During a 6-month period, paediatric patients (< 18 years old) who underwent tracheal intubation in their ED were included in the study.

CPR 52

CPR Emergency Department ALS ICU 52

ACEP Now

NOVEMBER 7, 2023

A 67-year-old man presents to the emergency department (ED) in cardiac arrest. On ED presentation, he is unresponsive and the monitor shows ventricular fibrillation. Emmerson AC, Whitbread M, Fothergill RT. He was found by bystanders after he collapsed and 911 was called. Canadian Journal of Emergency Medicine. 20(S1):S67.

Defibrillator 52

Defibrillator E-9-1-1 ALS Epinephrine 52