ALS Paramedic STEMI 
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%
The Skeptics' Guide to EM
SEPTEMBER 11, 2021
Date: September 8th, 2021 Reference: Desch et al. Date: September 8th, 2021 Reference: Desch et al. The paramedics achieve return of spontaneous circulation (ROSC) after CPR, advanced cardiac life support (ALCS), and Intubation. The TOMAHAWK Investigators. first appeared on The Skeptics Guide to Emergency Medicine.
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Dr. Smith's ECG Blog
JULY 7, 2024
So while there’s no diagnostic STEMI criteria, there are multiple ischemic abnormalities in 11/12 leads involving QRS, ST and T waves, which are diagnostic of a proximal LAD occlusion. First trop was 7,000ng/L (normal 25% of ‘Non-STEMI’ patients with delayed angiography have the exact same pathology of acute coronary occlusion.
Dr. Smith's ECG Blog
FEBRUARY 13, 2023
Written by Jesse McLaren Two 70 year olds had acute chest pain with nausea and shortness of breath, and called paramedics. There’s inferior ST depression which is reciprocal to subtle lateral convex ST elevation, and the precordial T waves are subtly hyperacute – all concerning for STEMI(-)OMI of proximal LAD. Who needs the cath lab?
EMS 12-Lead
APRIL 14, 2022
Madden, Paramedic. There is mixed overlap of ST-segment elevation (STE), ST-segment depression (STD), Hyperacute T waves (HATW), and deWinter pattern (which the ACC regards as a STEMI-equivalent but is better suited under the blanket of OMI). Let's revisit the deWinter occlusion provided by Paramedic Madden. 2] Costanzo, L.
Dr. Smith's ECG Blog
OCTOBER 17, 2024
Patient 1 : a 75 year old called paramedics with one day of left shoulder pain which migrated to the central chest, which was worse with deep breaths. The prehospital and ED computer interpretation was inferior STEMI: There’s normal sinus rhythm, first degree AV block and RBBB, normal axis and normal voltages. Vitals were normal.
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.
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