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A 40-something presented after attempted prehospital resuscitation with persistent Ventricular Fibrillation

Dr. Smith's ECG Blog

He underwent further standard resuscitation EXCEPT that we applied the Inspiratory Threshold Device ( ResQPod ) AND applied Dual Sequential Defibrillation (this simply means we applied 2 sets of pads, had 2 defib machines, and defibrillated with both with only a fraction of one second separating each defibrillation.

E-9-1-1 98
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What Lies Beneath

EMS 12-Lead

Question 1: What is the rhythm? We can, therefore, put down the defibrillation pads, set aside the amiodarone, and look further at the ECG. Beat 1 : Sinus, narrow QRS complex. The assumption is that a premature complex discharged prior to Beat 1, which prolonged its respective refractory period in the same manner as Beat 5.

E-9-1-1 130
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Upon arrival to the emergency department, a senior emergency physician looked at the ECG and said "Nothing too exciting."

Dr. Smith's ECG Blog

mm of ST segment elevation, V2 and V3 have 1 mm of elevation, v4 has 2 mm of elevation and v5 around 1.5 She was defibrillated and resuscitated. Note 1: Levels were significantly lower in takotsubo that presented with T-wave inversion. Reference on Troponins: Xenogiannis I, Vemmou E, Nikolakopoulos I, et al. V1 has 0.5

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Patient is informed of her husband's death: is it OMI or it stress cardiomyopathy?

Dr. Smith's ECG Blog

1:45, case start To orient you to this screen, the top is obviously ECG waveforms. The arterial pressure waveform is transduced using the coronary catheter. But in the case of an ostial lesion, there is little or no space between the outside of the catheter and the wall of the coronary artery.

E-9-1-1 77
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Acute coma, then Sudden PEA arrest in front of paramedics, with STEMI?

Dr. Smith's ECG Blog

Moreover, it does not follow a coronary distribution very well. The coronaries were clean. Today's patient unfortunately developed PEA ( P ulseless E lectrical A ctivity ) arrest shortly after arrival of the medic team. This is unusual in acute OMI. In addition, there is STE in V3-V6, so there is massive injury. From this site.

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