ACEP Now

DECEMBER 6, 2024

After the fourth defibrillation attempt, 200 mcg IV NTG was administered, resulting in immediate return of spontaneous circulation with a junctional bradycardia rhythm. Cardiac arrest secondary to myocardial ischemia from coronary vasospasm is well documented. References Prinzmetal M, Kennamer R, Merliss R, et al. N Engl J Med.

Coronary 98

Coronary Life Support ALS Emergency Department 98

Dr. Smith's ECG Blog

JULY 21, 2024

He required multiple defibrillations within a period of a few hours. This time, the arrhythmia did not spontaneously terminate — but rather degenerated to VFib, requiring defibrillation. In both tracings — an exceedingly fast PMVT is documented. Below are printouts of some of the arrhythmias recorded. What do you think?

Defibrillator 131

Defibrillator Coronary ALS STEMI 131

EMDocs

SEPTEMBER 23, 2023

Brugada sign refers to the findings on ECG, while Brugada syndrome is the combination of ECG findings with one of the following: documented ventricular tachycardia or fibrillation, syncope, family history of sudden cardiac death at < 45 years old, or inducible ventricular tachycardia with programmed electrical stimulation. Circulation.

E-9-1-1 105

E-9-1-1 EMS ALS Defibrillator 105

EMDocs

FEBRUARY 9, 2024

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. It is recommended to use an unsynchronized setting as the defibrillator may not be able to track the R-wave in the polymorphic waveform.

Defibrillator 96

Defibrillator OR ED ALS 96

Dr. Smith's ECG Blog

SEPTEMBER 2, 2024

This episode self terminated before defibrillation was possible. See Costagliola et al — Ann Clin Transl Neurol 8(7): 1557-1568, 2021 — for more on the complex "Brain-Heart Interaction" in Epilepsy ). This run of TdP is initiated by a PVC — but it then self-terminates. Discussion : The patient in today’s case presented with "seizures".

E-9-1-1 113

E-9-1-1 ALS Defibrillator OR 113

Don't Forget the Bubbles

JULY 26, 2023

Stredder et al, Archives of Disease in Childhood 2016 we see that 58% were not asked about triggers, 30% were not asked about duration and, importantly for risk stratification, 59% were not asked for a family history of cardiac disease. Where there are a number of unexplained deaths, start to be more critical about what this could mean.

ALS 98

ALS ED OR CPR 98

Dr. Smith's ECG Blog

JANUARY 30, 2019

Our patient had a Brugada Type 1 pattern elicited by an elevated core temperature, which is also a documented phenomenon. 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.

E-9-1-1 52

E-9-1-1 CAD STEMI OR 52