Defibrillator and E-9-1-1 - Paramedicine Now

Seizure in a 30 something

Dr. Smith's ECG Blog

SEPTEMBER 2, 2024

ECG #1 Interpretation: ECG #1 shows sinus rhythm at a heart rate of 77 bpm. This episode self terminated before defibrillation was possible. Following more detailed questioning — it turned out the patient had started taking 9 different herbal remedies to ease lethargy and unspecific neurological symptoms. and magnesium 0.88

E-9-1-1

E-9-1-1 ALS Defibrillator OR

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

Dr. Smith's ECG Blog

JULY 14, 2023

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

E-9-1-1 Defibrillator CPR STEMI

EM@3AM: Brugada Syndrome

EMDocs

SEPTEMBER 23, 2023

Answer : Brugada Syndrome Epidemiology and Etiology Rare genetic disorder that affects approximately 1 in 5,000 individuals worldwide 1. More common in males than females, with a male-to-female ratio of approximately 8:1 1. Type 1 “Brugada sign” The only type that is considered diagnostic.

E-9-1-1

E-9-1-1 EMS ALS Defibrillator

What Lies Beneath

EMS 12-Lead

AUGUST 22, 2022

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

E-9-1-1 Coronary ALS ICU

First10EM Journal Club: October 2022

Broome Docs

OCTOBER 31, 2022

2022 Jan;48(1):78-91. 2022 Sep;21(9):781-791. PMID: 30206143 Less is more when it comes to intravenous fluids de-Madaria E, Buxbaum JL, Maisonneuve P, et al. PMID: 35490863 Hands on defibrillation: Even if it’s safe, would it actually help? PMID: 35942482 earing gloves, hands on defibrillation is probably safe.

E-9-1-1

E-9-1-1 Defibrillator ICU Critical Care

Hyperthermia and ST Elevation

Dr. Smith's ECG Blog

JANUARY 30, 2019

The pattern of STE and STD reminded us of Brugada Type 1 morphology. Smith comment: 1) Brugada ECG may have ST shifts in limb leads as well as precordial leads. Patients that develop a Type 1 pattern without any precipitating or provoking factors have a risk of SCD of 0.5-0.8% per year incidence of SCD in this cohort [1].

E-9-1-1

E-9-1-1 CAD STEMI OR

Calcium in Out-of-Hospital Cardiac Arrest

NAEMSP

APRIL 19, 2023

CPR is taken over by responding crews, and he is placed on a cardiac monitor/defibrillator. After several cycles of defibrillation, epinephrine, and amiodarone, the patient remains in cardiac arrest. References: 1. His family has been performing bystander, and report that he suddenly collapsed just a few minutes ago. Ramazan, K.,

E-9-1-1

E-9-1-1 Advanced Life Support Overdose CPR

First10EM Journal Club: January 2023

Broome Docs

JANUARY 30, 2023

Defibrillation Strategies for Refractory Ventricular Fibrillation. PMID: 33933300 Khan A, Saleem MS, Willner KD, Sullivan L, Yu E, Mahmoud O, Alsaid A, Matsumura ME. 2022 Sep 1;5(9):e2235575. doi: 10.1007/s00381-022-05455-1. N Engl J Med. 2022 Nov 6. doi: 10.1056/NEJMoa2207304. Epub ahead of print. JAMA Netw Open.

E-9-1-1

E-9-1-1 Defibrillator Emergency Department ALS

Cardiac Care Show – Episode 1: Mechanical CPR

ECG Medical Training

DECEMBER 4, 2016

Cardiac Care Show – Episode #1: Mechanical CPR Hello, and welcome to the Cardiac Care Show. Let’s also not forget that these patients still require ventilation and they still require defibrillation! References Levy M, Yost D, Walker RG, Scheunemann E, Mendive SR. doi:10.1016/s0140-6736(14)61886-9. The Lancet.

CPR

CPR E-9-1-1 Defibrillator Ambulance

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

Dr. Smith's ECG Blog

NOVEMBER 30, 2022

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

Emergency Department

Emergency Department E-9-1-1 Coronary STEMI

What Is the Best Defibrillation Strategy for Refractory Ventricular Fibrillation?

ACEP Now

NOVEMBER 7, 2023

Multiple attempts at defibrillation, epinephrine, and amiodarone have been unsuccessful. Problem What is the best defibrillation strategy to treat refractory ventricular fibrillation? 2,3 Multiple published studies have addressed treatment of ventricular fibrillation with defibrillation and medications such as amiodarone and lidocaine.

Defibrillator

Defibrillator E-9-1-1 ALS Epinephrine

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

Dr. Smith's ECG Blog

MARCH 8, 2025

1:45, case start To orient you to this screen, the top is obviously ECG waveforms. 1:51, diagnostic RCA angiography At this point, the patient very clearly has a diagnosis of OMI, especially since we visualized embolism within the PDA. She was defibrillated perhaps 25 times. & Falk, E. Papadopoulou, E.,

E-9-1-1

E-9-1-1 OR Defibrillator Coronary

Acute coma, then Sudden PEA arrest in front of paramedics, with STEMI?

Dr. Smith's ECG Blog

FEBRUARY 20, 2025

Today's patient unfortunately developed PEA ( P ulseless E lectrical A ctivity ) arrest shortly after arrival of the medic team. Today's Initial ECG In the absence of a history interpretation of today's initial ECG ( that I've reproduced as the TOP tracing in Figure-1 ) is clearly worrisome. There is sinus tachycardia at ~115/minute.

STEMI

STEMI Paramedic E-9-1-1 Epinephrine

Case Report: Cardiac Arrest in a Child’s Structurally Normal Heart

ACEP Now

OCTOBER 29, 2024

EMS found the patient pulseless and apneic, with an initial rhythm showing ventricular fibrillation (see figure 1). He was defibrillated twice and received two doses of epinephrine, with return of spontaneous circulation. Figure 1: The EMS rhythm strip. Type 3 is indicated by J point and ST elevation < 1 mm.

E-9-1-1

E-9-1-1 Defibrillator ALS Epinephrine

Paramedicine Now

Seizure in a 30 something

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

Trending Sources

EM@3AM: Brugada Syndrome

What Lies Beneath

First10EM Journal Club: October 2022

Hyperthermia and ST Elevation

Calcium in Out-of-Hospital Cardiac Arrest

First10EM Journal Club: January 2023

Cardiac Care Show – Episode 1: Mechanical CPR

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

What Is the Best Defibrillation Strategy for Refractory Ventricular Fibrillation?

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

Acute coma, then Sudden PEA arrest in front of paramedics, with STEMI?

Case Report: Cardiac Arrest in a Child’s Structurally Normal Heart

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