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Peculiar ST and QT

EMS 12-Lead

David Didlake, FF/EMT-P, AG-ACNP @DidlakeDW An elder female presented to the ED with worsening shortness of breath. She was known to have a history of poorly controlled COPD, AFib, and multivessel coronary disease. There is bradycardic Atrial Fibrillation with broad ST-depression in most leads and perceptible ST-elevation in aVR.

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The Cardiovascular System for EMTs: Interventions and Heart Conditions

EMT Training Station

As an Emergency Medical Technician (EMT), your knowledge of this intricate system, the conditions that can arise, and the interventions necessary to save lives is fundamental to your role. Let’s dive in and unravel the complexities of the cardiovascular system and the crucial role you play as an EMT in managing heart conditions.

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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

The fire department, who operate at an EMT level in this municipality, arrived before us and administered 324 mg of baby aspirin to the patient due to concern for ACS. Such cases are classified as MINOCA (Myocardial Infarction with Non-Obstructed Coronary Arteries). V1 has 0.5 mm of elevation. ng/mL [IQR: 0.46, 2.35].

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50 year old with acute chest pain, with ‘normal’ ECG and falling troponin

Dr. Smith's ECG Blog

But STEMI criteria has poor sensitivity for acute coronary occlusion. Like the initial hemoglobin level in acute hemorrhage, the initial troponin in acute coronary occlusion can be falsely reassuring. In the STEMI paradigm, patients with ischemic symptoms and ECGs that don’t meet STEMI criteria get serial ECGs.

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