ACS Defibrillator ED 
Dr. Smith's ECG Blog
JULY 25, 2024
He was defibrillated into VT. He then underwent dual sequential defibrillation into asystole. The patient was brought to the ED and had this ECG recorded: What do you think? Then assume there is ACS. See these related cases: Cardiac arrest, defibrillated, diffuse ST depression and ST Elevation in aVR.
Dr. Smith's ECG Blog
APRIL 2, 2024
He was defibrillated, but they also noticed that he was being internally defibrillated and then found that he had an implantable ICD. He was unidentified and there were no records available After 7 shocks, he was successfully defibrillated and brought to the ED. Here is the initial ED ECG. What do you think?
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The Skeptics' Guide to EM
SEPTEMBER 11, 2021
He is interested and experienced in healthcare informatics, previously worked with ED-directed EMR design, and is involved in the New York City Health and Hospitals Healthcare Administration Scholars Program (HASP). She arrives in the emergency department (ED) with decreased level of consciousness and shock.
Dr. Smith's ECG Blog
APRIL 24, 2015
Here was his initial ED ECG: There is atrial fibrillation with a rapid ventricular response. Does this patient have ACS? Again, it is common to have an ECG that shows apparent subendocardial ischemia after resuscitation from cardiac arrest, after defibrillation, and after cardioversion. He did not have ACS.
Dr. Smith's ECG Blog
SEPTEMBER 3, 2023
This is diagnostic of ACS; it appears to be a reperfused acute inferior OMI. VF was refractory to amiodarone, lidocaine, double-sequential defibrillation, esmolol, etc. Then the patient would have been taken to the critical care area with a defibrillator at his side while waiting for the cath lab to be ready.
Dr. Smith's ECG Blog
OCTOBER 20, 2024
The ST segment changes are compatible with severe subendocardial ischemia which can be caused by type I MI from ACS or potentially from type II MI (non-obstructive coronary artery disease with supply/demand mismatch). The arrhythmia spontaneously converted before defibrillation was achieved.
EMDocs
JANUARY 8, 2024
This post will focus on the key parts of the guideline that affect ED evaluation and management. With respect to timing, for cardiac arrest with a shockable rhythm, it may be reasonable to administer epinephrine after initial defibrillation attempts have failed. COR 2b, LOE C-LD. COR 3, No benefit, LOE B-R. COR 2b, LOE B-R.
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