ACS Paramedic STEMI 
EMS 12-Lead
APRIL 14, 2022
Madden, Paramedic. It should be emphasized here that this is a presentation of high-pretest probability for Acute Coronary Syndrome (ACS). An interesting comment provided by Paramedic Madden is that a few team members initially interpreted the T wave presentation as hyperkalemia, as opposed to occlusive hyperacuity.
Dr. Smith's ECG Blog
AUGUST 11, 2024
Below is the first ECG recorded by paramedics after 2 hours of chest pain, interpreted by the machine as “possible inferior ischemia”. While STEMI negative, the ECG is diagnostic of proximal LAD occlusion. In isolation this ECG does not show OMI, but following the paramedic ECGs this indicates spontaneous LAD reperfusion.
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EMS 12-Lead
JUNE 20, 2022
David Didlake Firefighter / Paramedic Acute Care Nurse Practitioner @DidlakeDW Peer review provided by Dr. Steve Smith @SmithECGblog I was conducting QA/QI on two very recent cases and was struck by the uniqueness of both. A prehospital STEMI activation was transmitted to the closest PCI center, and 324mg ASA was administered.
The Skeptics' Guide to EM
SEPTEMBER 11, 2021
The paramedics achieve return of spontaneous circulation (ROSC) after CPR, advanced cardiac life support (ALCS), and Intubation. Acute coronary syndrome (ACS) is responsible for the majority (60%) of all OHCAs in patients. EMS arrives and finds the patient in monomorphic ventricular tachycardic (VT) cardiac arrest.
Dr. Smith's ECG Blog
APRIL 18, 2024
Paramedics provided another 3 sprays of nitro, and 6mg of morphine, which reduced but did not resolve the pain. I sent this to the Queen of Hearts So the ECG is both STEMI negative and has no subtle diagnostic signs of occlusion. of such ‘high risk Non-STEMI’ patients get angiography within 2 hours.[2] But only 6.4%
ECG Medical Training
AUGUST 21, 2016
Acute anterior STEMI tends to be a more difficult ECG diagnosis than acute inferior STEMI. That’s because with acute inferior STEMI there’s almost always a downsloping ST-segment in lead aVL to help shore up the diagnosis. Assuming the patient has signs and symptoms of ACS, this should be an easy diagnosis.
EMS 12-Lead
APRIL 2, 2022
David Didlake Firefighter / Paramedic Acute Care Nurse Practitioner @DidlakeDW Expert commentary provided by Dr. Ken Grauer CASE 1 An 82 y/o Male called 911 for sudden onset dizziness while at rest. Anecdotally, had there been symptoms unequivocally consistent with ACS then one could justifiably make the case for a potential D1 occlusion.
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