Remove Coronary Remove EMR Remove Paramedic
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SGEM#344: We Will…We Will Cath You – But should We After An OHCA Without ST Elevations?

The Skeptics' Guide to EM

He is interested and experienced in healthcare informatics, previously worked with ED-directed EMR design, and is involved in the New York City Health and Hospitals Healthcare Administration Scholars Program (HASP). The paramedics achieve return of spontaneous circulation (ROSC) after CPR, advanced cardiac life support (ALCS), and Intubation.

EMR 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

This case was provided by Spencer Schwartz, an outstanding paramedic at Hennepin EMS who is on Hennepin EMS's specialized "P3" team, a team that receives extra training in advanced procedures such as RSI, thoracostomy, vasopressors, and prehospital ultrasound. One need not have obstructive coronary disease to have occlusive thrombus!

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LBBB: Using the (Smith) Modified Sgarbossa Criteria would have saved this man's life

Dr. Smith's ECG Blog

The paramedics found the patient with ROSC and a GCS 7, and an ECG showing LBBB with possible lateral ST elevation. This ALONE is very strong evidence of acute coronary occlusion. The patient was brought to the ED as a possible Code STEMI and was seen directly by cardiology. Any indications for cath lab activation?

EMR 52