REBEL EM

JUNE 1, 2023

Article: Branch KHR et al. Known cardiac defibrillator. References: Branch KHR et al. appeared first on REBEL EM - Emergency Medicine Blog. In theory, rapid identification of the underlying cause should improve outcomes by allowing clinicians to tailor management. Resus 2023. Pre-existing DNR order. Resus 2023.

Coronary 145

Coronary Defibrillator CPR ALS 145

Dr. Smith's ECG Blog

JUNE 21, 2023

Two hours later , the patient returned to this same urgent care facility with worsening chest pain, and this ECG was performed: While getting another ECG, the patient suffered cardiac arrest: After multiple defibrillations, ROSC was achieved with ongoing "STEMI". Most OMI have a peak Troponin T over 1000 ng/L [reference: Baro R et al.

STEMI 97

STEMI Coronary Defibrillator EMS 97

Dr. Smith's ECG Blog

SEPTEMBER 16, 2024

After resuscitation and defibrillation , there were no more episodes of TdP. Below is the patient’s 12 lead ECG following defibrillation. Most Torsades is the result of a pause-dependent effect that predisposes to development of the malignant arrhythmia ( Dohadwala et al — Heart Rhythm Case Rep 3(2):115-119, 2017 ).

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Defibrillator Coronary OR ALS 68

EMDocs

FEBRUARY 9, 2024

Adapted from Dr. Smith’s EKG Blog. Defibrillator pads are placed and you give 2 g IV magnesium over ten minutes. Figure 3/ Adapted from Wilde et al. A complete approach to treating cLQTS can be found in Wilde et al 2. An ECG is performed and is shown below: Figure 1. The patient is awake and protecting her airway.

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Defibrillator OR ED ALS 71

REBEL EM

SEPTEMBER 19, 2022

Background: There are only two interventions that have been proven in the medical literature to improved outcomes in cardiac arrest: high-quality CPR and early defibrillation. Article: Moore JC et al. References: Moore JC et al. It is imperative that we continue to look at ways to improve cardiac arrest resuscitation.

CPR 52

CPR Defibrillator EMS Epinephrine 52

Dr. Smith's ECG Blog

JANUARY 15, 2024

ECG 2 Especially in the context of the first ECG, readers of this blog will readily appreciate the ST elevations and hyperacute T waves in II, III, aVF, V6, and to a lesser extent V5. As discussed on this blog many times before, proportionality is key to the diagnosis of OMI by ECG. [link] I also texted the ECG to Dr. Smith.

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Critical Care Defibrillator OR ALS 64

Dr. Smith's ECG Blog

JANUARY 23, 2024

She was given CRT-D (Cardiac Resynchronization Therapy-Defibrillator). Learning points: == MY Comment , by K EN G RAUER, MD ( 1/15 /2024 ): == Today's case by Dr. Nossen differs from other cases of AV block we have published over the years in Dr. Smith's ECG Blog — in that the cause of AV block turned out to be CS ( C ardiac S arcoidosis ).

Coronary 85

Coronary OR Defibrillator ALS 85

Dr. Smith's ECG Blog

FEBRUARY 8, 2022

The patient was put on Extracorporeal Life Support in the ED 3 hours after initial resuscitation, the core temp was 30° C and the patient was defibrillated with a single attempt. Rituparna et al — as well as Chauhan and Brahma ( Int. On arrival, CPR was continued and core temperature was measured at 18° C (64.4° This is an Osborn wave.

CPR 52

CPR Defibrillator Life Support ED 52

Dr. Smith's ECG Blog

NOVEMBER 30, 2022

She was defibrillated and resuscitated. Reference on Troponins: Xenogiannis I, Vemmou E, Nikolakopoulos I, et al. Lindahl et al. From Gue at al. Lindahl B, Baron T, Erlinge D, et al. Upon arrival to the emergency department, a senior emergency physician looked at the ECG and said "Nothing too exciting."

Emergency Department 52

Emergency Department E-9-1-1 Coronary STEMI 52

Dr. Smith's ECG Blog

FEBRUARY 13, 2023

Meyers et al. Aslanger et al. Lemkes et al. Bergmark et al. There was 100% proximal LAD occlusion, EF was 55% with severe hypokinesis to mid-distal septum and apex. First troponin I was 150 ng/L (normal <26 in males and <16 in females) and peak was 7,500. Int J Cardiol Heart Vasc 2021 2. Eur Heart J 2018 4.

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STEMI Paramedic Coronary ALS 52

REBEL EM

DECEMBER 19, 2022

Background Information: Double external defibrillation (DED) is an intervention often used to treat refractory ventricular fibrillation (RVF). This procedure involves applying another set of pads attached to a second defibrillator to a patient and shocking them in hopes of terminating the rhythm. N Engl J Med.

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Defibrillator Paramedic CPR EMS 52

Dr. Smith's ECG Blog

MARCH 15, 2023

We examined the effect of ibutilide, a class III antiarrhythmic agent, on the energy requirement for atrial defibrillation and assessed the value of this agent in facilitating cardioversion in patients with atrial fibrillation that is resistant to conventional transthoracic cardioversion.

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ALS OR Defibrillator ED 52

Dr. Smith's ECG Blog

JUNE 19, 2023

Armstrong et al. During angiogram in the cath lab, the patient suffered two episodes of ventricular fibrillation for which he was successfully defibrillated. We have tried to study it before, only to find that we cannot obtain enough cases of OMI with simultaneous high voltage in the leads with OMI findings, to study it.

STEMI 52

STEMI ACS Coronary Defibrillator 52

Dr. Smith's ECG Blog

MAY 6, 2019

Excerpted from Vutthikraivit et al: Acta Cardiol Sin 34:267-277, 2018 ). == Distinction is made between 2 types of Brugada ECG patterns: A B rugada - 1 ECG pattern — shows ≥2 mm coved ST elevation with sharp downslope plus T wave inversion in ≥2 anterior leads. Cardioversion/defibrillation. Acute febrile illness. Hypothermia.

STEMI 52

STEMI Defibrillator OR ALS 52

Dr. Smith's ECG Blog

JANUARY 30, 2019

In the largest study looking at this topic by Mizusawa et al., Recently the rate of true arrhythmic events related to fevers in the classic Brugada Type 1 syndrome was explored by Michowitz et al. 88 patients with fever induced Brugada Type 1 ECG changes without history of syncope or VF/VT were analyzed. There was a 0.9%

E-9-1-1 52

E-9-1-1 CAD STEMI OR 52

Dr. Smith's ECG Blog

NOVEMBER 30, 2019

the associated loss is double, at 200-400 mEq.* [ Sterns RH, et al. Here are other posts on hyperK, large calcium doses for hyperK, and ventricular tachycardia in hyperK Weakness, prolonged PR interval, wide complex, ventricular tachycardia Very Wide and Very Fast, What is it? How would you treat? Medicine (Baltimore) 1981;60:339-54].

Plasma 52

Plasma STEMI Defibrillator Overdose 52

Dr. Smith's ECG Blog

DECEMBER 5, 2019

Bayes de Luna, A et al. This is based on the Sieira et al, 2017, risk calculator , which gives a borderline risk score (2). An EP study might be helpful in symptomatic patients (Sroubek et al., Current electrocardiographic criteria for diagnosis of Brugada pattern: a consensus report. J Electrocardiology 45 (2012):433-442.

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ALS OR Defibrillator STEMI 52