Dr. Smith's ECG Blog

JULY 3, 2018

While in the emergency department, he undergoes an additional ECG: 00:49 - Not much change Second ECG with measurements and calculations Magnified view of second ECGs measurements and calculation It is still "negative" for LAD occlusion (less than 23.4) . - The ST elevation from today is ~0.2 mV compared to 0.05-0.1

ACS 52

ACS STEMI Coronary CAD 52

Dr. Smith's ECG Blog

JANUARY 9, 2024

She presented to the emergency department after a couple of days of chest discomfort. Ischemia from ACS causing the chest discomfort, with VT another consequence (or coincidence)? She had a single chamber ICD/Pacemaker implanted several years prior due to ventricular tachycardia. The ECG below was recorded.

Coronary 119

Coronary ACS ED OR 119

ACEP Now

MARCH 14, 2024

A 44 year-old male with unknown past medical history came by emergency medical services (EMS) to the emergency department (ED) for an electrical injury and fall from a high voltage electrical pole. 2,3,5 Except for laundry or electrical car outlets (240 V AC), all U.S. household outlets are rated at 120 V AC.

Operating Room 52

Operating Room ACS Critical Care Coronary 52

NCOAE

DECEMBER 11, 2023

The Eastern Association for the Surgery of Trauma (EAST) , the National Association of EMS Physicians (NAEMSP) , and the American College of Surgeons Committee on Trauma (ACS-COT) all support the recommendation against the use of spinal immobilization in patients with isolated penetrating injuries.

OR 52

OR Emergency Medical Technician Emergency Department Emergency Medical Services 52

Dr. Smith's ECG Blog

APRIL 17, 2023

He had no symptoms of ACS. The remainder of his Emergency Department stay was uneventful. Here is the clinical informaton on ECG 2: A man in his 50s presented to the Emergency Department with acute chest pain that started within the past few hours. Chest pain is documented as ongoing. Physician: "No STEMI."

OR 52

OR STEMI ACS Emergency Department 52

Dr. Smith's ECG Blog

OCTOBER 2, 2021

Because the patient's pain had resolved completely and cardiology had declined immediate intervention, the patient was admitted but continued to board in the emergency department. Approximately 4 hours after arrival, the patient was re-examined by the emergency physician. There is no age cut-off for ACS. 1] Wereski, R.,

OR 52

OR ACS STEMI Coronary 52

Dr. Smith's ECG Blog

NOVEMBER 26, 2015

52-year-old lady presents to the Emergency Department with 2 hours of chest pain, palpitations & SOB. Beware of ACS presenting with atypical symptoms, including absence of chest pain. This was written by Sam Ghali ( @ EM_RESUS ), with a few edits by me. She is somewhat hypertensive, but her vital signs are otherwise normal.

STEMI 52

STEMI ACS Emergency Department OR 52

EMDocs

FEBRUARY 12, 2024

ABG and VBG Correlation The correlation between venous and arterial blood gases is well-documented for standard differences (Table 1), and the data obtained from the VBG can be acted on as if it were an ABG (1, 3-6). Int J Emerg Med. The role of venous blood gas in the emergency department: a systematic review and meta-analysis.

Emergency Department 98

Emergency Department E-9-1-1 ED ICU 98

ECG & Echo Learning

JANUARY 18, 2023

IIa C Pre-hospital logistics Management Recommendation Level of evidence The pre-hospital care of STEMI patients should be organized regionally (including all components from the emergency medical dispatch to catheterization laboratory) in order to provide reperfusion therapy as early as possible.

STEMI 40

STEMI Coronary OR Defibrillator 40

Dr. Smith's ECG Blog

APRIL 8, 2015

Thus, if there is documented sinus bradycardia, and no suspicion of high grade AV block, at the time of the syncope, this is very useful. 2) Boston syncope rule: J Emerg Med. The ROSE (Risk Stratification of syncope in the emergency department) Study. 2007 Oct; 33(3): 233–239.

Emergency Department 52

Emergency Department E-9-1-1 ED ALS 52

AAEM RSA

DECEMBER 3, 2020

Introduction: While cases of genital gangrene were documented as early as 980 CE, the condition we know today as FG was coined in the 1880’s by French venerologist, Jean Alfred Fournier. Wysoki MG, Santora TA, Shah RM, Friedman AC. West J Emerg Med. West J Emerg Med. Fournier gangrene. A retrospective study of 41 cases].

Emergency Department 52

Emergency Department E-9-1-1 ALS EMT 52

Dr. Smith's ECG Blog

JUNE 8, 2023

As recurrent ischaemia is the principle event reduced by early intervention in NSTE-ACS, these are important endpoint events occurring with delayed angiography and there is a consistent signal for harm now from two data sources.”[5] 5] This patient had ongoing chest pain, bradycardia, and no signs of reperfusion T wave inversion. Welsh et al.

STEMI 86

STEMI Coronary Paramedic ALS 86

Don't Forget the Bubbles

JULY 5, 2023

Opioids do not cause ACS but they can exacerbate hypoxia in patients with ACS. A 6-year-old girl from Saudi Arabia was referred by her General Practitioner to the local emergency department. Mechanical or non-invasive ventilation : children with ACS may require ventilatory support.

E-9-1-1 126

E-9-1-1 ACS OR ICU 126

Dr. Smith's ECG Blog

DECEMBER 31, 2024

She presented to the Emergency Department at around 3.5 But thankfully, when the clinical context is clearly and highly concerning for ongoing ischemia from ACS, this distinction doesn't matter much. She was emergently transferred to a PCI center. Vital signs were within normal limits. hours since onset.

Coronary 119

Coronary ACS STEMI CAD 119

ACEP Now

FEBRUARY 19, 2025

Emergency medicine (EM) is a team-based specialty, where a diverse group works together to rapidly deliver acute, unscheduled patient care. In contrast to traditional teams that have the luxury of time for their members to build rapport, teams in the emergency department (ED) change every day. References Edmondson AC.

E-9-1-1 51

E-9-1-1 ALS ED Emergency Department 51

Dr. Smith's ECG Blog

JANUARY 15, 2025

Case A 68 year old man with a medical history of hypertension, hyperlipidemia, and CAD with stent deployment in the RCA presented to the emergency department with chest pain. html ) Despite an undetectable troponin and three normal EKGs, the nature of the patients symptoms and his positive cardiac history warranted concern for ACS.

Coronary 68

Coronary ED CAD Paramedic 68

EMDocs

JANUARY 6, 2025

4,5 Of particular concern is the Sudanese conflict, which began in April 2023, and which has caused the largest internal displacement of a population in documented history. link] Hummell AC, Cummings M. HIV Prevention and Treatment: The Evolving Role of the Emergency Department. Ann Emerg Med. 2022;37(1):41-49.

ED 75

ED E-9-1-1 ALS Emergency Department 75