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Defining Appropriate Responses in a Tiered System

High Performance EMS

Dispatching the right unit to an EMS call was much simpler when all resources had the same capabilities and a response time was the primary measure of success. It was a matter of determining which crew was available closest to the scene.

BLS 264
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Elder Male with Syncope

EMS 12-Lead

David Didlake @DidlakeDW EMS personnel responded to the residence of an 81 y/o Male with syncope. 2. Coronary angiography reveals significant and severe CAD involving all three epicardial vessels. His spouse had called 911 after she heard a loud “thud” in the adjacent room. He was taken to the Cath Lab.

Coronary 290
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(Q4/2024) ESO Updates: Quarterly Product Enhancements

ESO

Were making the jump to general availability (GA) and adding new features such as CAD and Cardiac Monitor integrations, Longitudinal Record (LR), and Mobile-to-Mobile functionality. This basic version will not include auto-import configuration, and integrations with CAD and EHR will not be added until upcoming releases in 2025.

MIH 98
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Wide Complex Tachycardia

EMS 12-Lead

He denied any known history of CAD, but did report ASCVD risk factors to include HTN, HLD, and DM. David Didlake EMT-P, RN, ACNP @DidlakeDW An adult male self-presented to the ED with palpitations and the following ECG. The patient was very uncomfortable, dyspneic, and displayed an SpO2 90% on RA.

CAD 147
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An undergraduate who is an EKG tech sees something. The computer calls it completely normal. How about the physicians?

Dr. Smith's ECG Blog

A 63 year old man with a history of hypertension, hyperlipidemia, prediabetes, and a family history of CAD developed chest pain, shortness of breath, and diaphoresis after consuming a large meal at noon. He called EMS, who arrived on scene about two hours after the onset of pain to find him hypertensive at 220 systolic.

CAD 125
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Expert human ECG interpretation and/or the Queen of Hearts could have saved this patient's anterior wall

Dr. Smith's ECG Blog

A man in his mid 60s with history of CAD and stents experienced sudden onset epigastric abdominal pain radiating up into his chest at home, waking him from sleep. He called EMS who brought him to the ED. Here is the EM decision making: "The patient's EKG revealed some repolarization abnormalities but no clear signs of a STEMI.

OR 127
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Formula Utilization

EMS 12-Lead

Moreover, he had no pertinent medical history to report in terms of CAD, HTN, HLD, or DM, for example. According to the EMS narrative, this patient initially refused hospital transport and advised that he would seek evaluation at a later time with his personal physician. A 12 Lead ECG was recorded. A 12 Lead ECG was recorded.

ACS 130