International Journal of Paramedicine

JULY 8, 2024

This included date, POE, patient demographics, chief complaint, computer-aided dispatch (CAD), provider impression (diagnosis), and time out of service. Results : Over the study period, 8,407 encounters occurred at one of the three El Paso-Juárez POE, averaging 1,680 per year or 140 calls per month.

Prehospital Care Provider 52

Prehospital Care Provider Emergency Medical Services CAD EMS 52

NVFC

JULY 16, 2024

Once the new system is in place, it will also be able to integrate information from the computer-aided dispatch system (CADS). By Tom Jenkins Reprinted from the 2024 issue of Firefighter Strong In the fire academy, I doubt any candidate firefighter is excited or intrigued about incident reporting.

Firefighter 105

Firefighter Emergency Response CAD OR 105

Dr. Smith's ECG Blog

FEBRUARY 12, 2024

(THE PM CARDIO OMI AI APP) If you want this bot to help you make the early diagnosis of OMI and save your patient and his/her myocardium, you can sign up to get an early beta version of the bot here.

CAD 83

CAD ED OR Coronary 83

Dr. Smith's ECG Blog

DECEMBER 5, 2023

He did have a family history notable for early CAD. hematological disorder like sickle cell or antiphospholipid syndome, family history of CAD or hypercholesterolemia, prior history of vasculopathies such as Kawasaki Disease, MIS-C, prior cardiac surgery, etc.) He denied drug or alcohol use.

Coronary 112

Coronary CAD ACS ALS 112

Dr. Smith's ECG Blog

MARCH 19, 2024

The patient presented to an outside hospital An 80yo female per triage “patient presents with chest pain, also hurts to breathe” PMH: CAD, s/p stent placement, CHF, atrial fibrillation, pacemaker (placed 1 month earlier), LBBB. HPI: Abrupt onset of substernal chest pain associated with nausea/vomiting 30 min PTA. This was stented with a 2.25

CAD 89

CAD STEMI ACS ALS 89

Dr. Smith's ECG Blog

APRIL 9, 2024

By Magnus Nossen This ECG is from a young man with no risk factors for CAD, he presented with chest pain. Before the lab values returned this patient had a n emergent coronary CT angiogram done that ruled out CAD. How would you assess this ECG? How confident are you in your assessment? What is your next step? How did the Queen do?

Coronary 89

Coronary CAD ACS OR 89

The Skeptics' Guide to EM

JULY 2, 2022

In prior decades nearly all patients presenting to EDs with chest pain were admitted to hospital. If we thought about ACS, we brought them in. This would be for objective cardiac testing including stress test, CT-angiography, and/or invasive angiography. Major adverse cardiac event rates in moderate-risk patients: Does prior coronary disease matter?

Coronary 100

Coronary Heart Attack ACS CAD 100

Dr. Smith's ECG Blog

DECEMBER 16, 2018

She had a normal EF, and no significant CAD, and was taking flecainide to suppress the AF. Wide-complex tachycardia: VT or aberrant, or "other?" This case is contributed by Brooks Walsh , an EM physician and ECG expert from Connecticut. The case An older woman presented to the ED with dyspnea, diaphoresis, and chest pressure.

OR 52

OR ED CAD Overdose 52

EMS 12-Lead

AUGUST 14, 2022

Otherwise, no admission of CAD, HLD, or family history of sudden cardiac death. There was no obvious pallor, diaphoresis, or dyspnea, and he denied any prior episodes of vomiting. He described the pain as “nagging,” and equally not exacerbated by any kind of movement. it has been subsequently deemed a STEMI-equivalent.

STEMI 130

STEMI MICU CAD Coronary 130

EMS 12-Lead

JULY 24, 2023

These concerns were readily conveyed to my supervising cardiologist with particular emphasis on high pretest probability for baseline advanced CAD (3-vessel disease, specifically) with a critically stenosed proximal LAD. This results in Type I MI. This results in Type II MI. What’s interesting is that the ECG can only detect ischemia.

Coronary 130

Coronary ACS CAD ED 130

Dr. Smith's ECG Blog

APRIL 14, 2023

Sent by Anonymous, written by Pendell Meyers A man in his 60s with history of CAD and 2 prior stents presented to the ED complaining of acute heavy substernal chest pain that began while eating breakfast about an hour ago, and had been persistent since then, despite EMS administering aspirin and nitroglycerin. Pre-intervention.

CAD 52

CAD ACS STEMI Coronary 52

EMDocs

NOVEMBER 29, 2023

Double-blind, placebo-controlled multicenter RCT Included 795 patients > 18 years admitted to the ICU with severe PNA Intervention: Hydrocortisone as a continuous infusion of 200 mg/day IV with a planned taper for 8 or 14 days compared to placebo Primary Outcome: All-cause mortality at 28 days Hydrocortisone 6.2% 1.40) Trial likely underpowered.

ICU 80

ICU CAD ALS OR 80

EMS 12-Lead

APRIL 8, 2022

Furthermore, there was no family history of early CAD, MI, or sudden cardiac death. A 56 y/o Male called 911 from his hotel room in the early morning hours after abruptly awakening from sleep with crushing chest discomfort and difficulty breathing. He reported to EMS a medical history of GERD only. He left AMA and is lost to follow-up.

STEMI 130

STEMI ALS Coronary CAD 130

EMS 12-Lead

JUNE 20, 2022

Moreover, he had no pertinent medical history to report in terms of CAD, HTN, HLD, or DM, for example. CASE 1 A 45 y/o Male called 911 for new onset central chest discomfort, non-radiating, 5/10 pain scale, and without any vomiting, diaphoresis, or pallor. A 12 Lead ECG was recorded. There is no dramatic change, or evolution.

ACS 130

ACS Coronary STEMI CAD 130

Dr. Smith's ECG Blog

JUNE 23, 2024

Stated differently, the differential diagnosis for the presenting syndrome was either ventricular fibrillation due to acute coronary syndrome, or idiopathic ventricular fibrillation and bystander stable CAD.

Coronary 107

Coronary CAD CPR Critical Care 107

Dr. Smith's ECG Blog

APRIL 18, 2024

Similarly, if a patient with known CAD presents with refractory ischemic chest pain, the ECG barely matters: the pre-test likelihood of acute coronary occlusion is so high that they need an emergent angiogram. 1] European guidelines add "regardless of biomarkers".

STEMI 118

STEMI Coronary ALS CAD 118

EMDocs

FEBRUARY 7, 2024

Increased risk in those with preexisting CKD, other risk factors for renal disease (HTN or CAD), and those on ACEIs/ARBs. The effects of GLP-1 agonists are associated with the dose. Higher doses of GLP-1 agonists are associated with weight loss. Take for example semaglutide. Ozempic is utilized for DM2 in doses of 0.5, mg SQ every week.

Allergic Reaction 74

Allergic Reaction ALS CAD OR 74

Emergency Medicine Ireland

DECEMBER 7, 2020

As the pregnant population continues to age and with RF and smoking and DM still common we can expect to see pregnant woman with CAD. Critical illness in pregnancy is remarkably rare given the somewhat bonkers system for reproduction that we seem to have evolved over the past million or years. Improved care of complex.

Critical Care 40

Critical Care CAD Plasma ACS 40

EM Literature of Note

OCTOBER 18, 2021

CTCA certainly has a role in the evaluation of patients with chest pain and possible CAD, but certainly not as a routine investigation in the ED. Patients were eligible by symptoms of an acute coronary syndrome, supported by ECG changes, an elevated troponin, or a history of ischemic heart disease.

Coronary 40

Coronary CAD ED OR 40

Dr. Smith's ECG Blog

JUNE 19, 2024

The ED provider ordered a coronary CT scan to assess the patient for CAD. Three months prior to this presentation, he received a pacemaker for severe bradycardia and syncope due to sinus node dysfunction. At around 1430, as the patient was being prepared to leave for the scan, he developed severe chest pain, dizziness, and became diaphoretic.

STEMI 62

STEMI Coronary CAD ED 62

Dr. Smith's ECG Blog

MAY 19, 2020

Diagnosis of MINOCA should be made according to the Fourth Universal Definition of MI, in the absence of obstructive coronary artery disease (CAD) (no lesion ≥50%). The authors recommend using optical coherence tomography or intravascular ultrasound imaging in patients with evidence of nonobstructive CAD by angiogram. The K was normal.

Defibrillator 52

Defibrillator CPR Coronary CAD 52

High Performance EMS

JANUARY 26, 2021

Your existing historical CAD records contain the necessary information to build such dynamic views in real-time. The next step is to adequately distribute those available resources spatially to address the variation over the geographic area by time which requires an even deeper understanding of the call patterns.

Emergency Response 100

Emergency Response Emergency Medical Services CAD Ambulance 100

Dr. Smith's ECG Blog

MARCH 19, 2023

Concerning history, known CAD" Recorded 2 hours after pain onset: What do you think? To realize — Assessment of ECG #1 is complicated by knowing: i ) That today’s patient has a history of documented CAD ; and , ii ) The lack o f a prior tracing for comparison at the time the initial ECG was interpreted.

STEMI 52

STEMI Coronary CAD OR 52

Dr. Smith's ECG Blog

JANUARY 9, 2023

No family history of sudden cardiac death, cardiomyopathy, premature CAD, or other cardiac issues. No similar symptoms in the past. No prior exertional complaints of chest pain, dizziness, lightheadedness, or undue shortness of breath. He denied headache or neck pain associated with exertion. No further troponins were measured. Pericarditis?

Coronary 52

Coronary STEMI Heart Attack OR 52

Dr. Smith's ECG Blog

NOVEMBER 3, 2023

A man in his 70s with past medical history of hypertension, dyslipidemia, CAD s/p left circumflex stent 2 years prior presented to the ED with worsening intermittent exertional chest pain relieved by rest. Written by Nathanael Franks MD, reviewed by Meyers, Smith, Grauer, etc. He was diagnosed as NSTEMI.

ACS 86

ACS Coronary ALS CAD 86

Dr. Smith's ECG Blog

NOVEMBER 26, 2018

The rhythm differential for narrow, regular, and tachycardic is sinus rhythm, SVT (encompassing AVNRT, AVRT, atrial tach, etc), and atrial flutter (another supraventricular rhythm which is usually considered separately from SVTs). Therefore this patient is either in some form of SVT or atrial flutter. Fatigued-appearing but mentating perfectly.

STEMI 52

STEMI ACS CAD OR 52

My Paramedic Blog

JULY 8, 2014

I hop into the ambulance, and log onto the CAD (Computer Assisted Dispatch) device. The call pops up onto our CAD. I look at the notes on the CAD it read: Crowning. Partner: “I’d prefer driving if you don’t mind.” Me: “Sure, that’s all good with me.” I wonder what intoxicated person we are going to pick up tonight. Me: “99 Fox.”

CAD 52

CAD Paramedic Ambulance Firefighter 52

Dr. Smith's ECG Blog

DECEMBER 6, 2010

He had no previous history of CAD, and presented with very typical waxing and waning chest pain, much worse with exertion but also present at rest and on presentation, though his pain was minimal at the time of the ECG. I saw this 59 year old male 3 weeks ago. Blood pressure was 150/80. The ECG normalized overnight. Maximum troponin was 2.1

STEMI 52

STEMI CAD OR 52

Dr. Smith's ECG Blog

JUNE 1, 2012

This was a middle aged female with a h/o CAD who presented to the ED by EMS sudden onset of central chest pressure 45 min prior to ED arrival with associated diaphoresis and SOB.  There is LVH and there are ST-T abnormalities (large inferior T-waves and ST elevation, with reciprocal findings in aVL).

STEMI 52

STEMI CAD ED EMS 52

Dr. Smith's ECG Blog

JUNE 12, 2017

He had a family history of early CAD and occasional drug and tobacco use. This was sent by : Jacob Smith, DO Emergency Medicine Resident Ohio Health Doctors Hospital Emergency Residency Christopher Lloyd, DO, FACEP Director of Clinical Education, USACS Midwest Case A 30 year old patient presents to triage with chest pain.

STEMI 52

STEMI CAD Coronary ALS 52

ECG & Echo Learning

JANUARY 18, 2023

I C Blood samples Management Recommendation Level of evidence Serum biomarkers of myocardial infarction ( troponin ) should be sampled as early as possible without delaying reperfusion therapy. I C Symptom relief Symptom Management Recommendation Level of evidence Hypoxia Oxygen is indicated if SaO2 < 90% or PaO2 < 60 mmHg.

STEMI 40

STEMI Coronary OR Defibrillator 40

Dr. Smith's ECG Blog

DECEMBER 13, 2019

They found non-obstructive CAD, with only a 20% stenosis of OM2 and 10% RCA. Several hours prior to presentation, while driving his truck, he started experiencing new central chest pain, without radiation, aggravating/alleviating factors, or other associated symptoms. No acute culprit. He was admitted to cardiology. Pericarditis?

E-9-1-1 52

E-9-1-1 ACS Coronary CAD 52

Dr. Smith's ECG Blog

SEPTEMBER 16, 2015

A middle-aged male with h/o CAD and stents presented with typical chest pressure. Here is his ECG: The resident was alarmed at the "ST elevation in III with reciprocal ST depression in aVL" Are you alarmed? This is a very common misread. It may be difficult to read STEMI in the setting of RBBB. The trick is to find the end of the QRS.

STEMI 52

STEMI CPR CAD Coronary 52

Dr. Smith's ECG Blog

JANUARY 28, 2018

He has a history of known CAD, diabetes, and dyslipidemia. This post was written by one of our fantastic Hennepin County Medical Center Emergency Medicine interns who is an ECG whiz, Daniel Lee. A man is his late 50’s presents to the ED with 1 hour of post exertional chest pressure associated with diaphoresis and nausea.

Coronary 52

Coronary STEMI CAD ED 52

Dr. Smith's ECG Blog

JULY 31, 2018

She had zero CAD risk factors. Post by Smith, with short article by Angie Lobo ( [link] ), a third year intermal medicine resident at Abbott Northwestern Hospital Case A 30-something woman with no past history, who is very fit and athletic, presented with 1.5 hours of substernal chest pressure. There is 1 mm of STE in lead V2.

Coronary 52

Coronary ACS STEMI OR 52

Dr. Smith's ECG Blog

SEPTEMBER 29, 2018

In this study of dialysis patients with severe CAD, 77% had an abnormal resting EKG and the most common abnormality was LVH. Another reason may be that the EKG is more difficult to interpret in patients with dialysis due to baseline abnormalities, including LVH. Herzog et al. What can we learn? Herein lies the “ART” of electrocardiography.

CAD 52

CAD OR ED ALS 52

Dr. Smith's ECG Blog

SEPTEMBER 4, 2016

A woman in her 60s with no prior history of CAD presented with 3 hours of sharp, centrally located chest pain with radiation to the anterior neck, with associated nausea. Jason asked me if I thought it is due to occlusion (without either of us knowing the outcome), and this was my answer: This is a posterolateral MI. Why did I say this?

E-9-1-1 52

E-9-1-1 STEMI Coronary CAD 52