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Source Use of Glucagon-Like Peptide-1-Agonists and Increased Risk of Procedural Sedation and Endotracheal Intubation in the EmergencyDepartment. Ann Emerg Med. 4: VF or VT – Earlier Defibrillation Is Better? 2024 Aug;84(2):226-227. DOI: 10.1016/j.annemergmed.2024.03.007. 2024.03.007. PMID: 39032988. #2: Pediatrics.
She arrives in the emergencydepartment (ED) with decreased level of consciousness and shock. Defibrillation is the treatment of choice in these cases but does not often result in sustained ROSC ( Kudenchuk et al 2006). She has a history of hypertension and non-insulin dependent diabetes mellitus.
This was sent by anonymous The patient is a 55-year-old male who presented to the emergencydepartment after approximately 3 to 4 days of intermittent central boring chest pain initially responsive to nitroglycerin, but is now more constant and not responsive to nitroglycerin. It is unknown when this pain recurred and became constant.
You can subscribe for news and early access (via participating in our studies) to the Queen of Hearts here: [link] queen-form This EMS ECG was transmitted to the nearby EmergencyDepartment where it was remotely reviewed by a physician, who interpreted it as normal, or at least without any features of ischemia or STEMI.
She was unable to be defibrillated but was cannulated and placed on ECMO in our EmergencyDepartment (ECLS - extracorporeal life support). After good ECMO flow was established, she was successfully defibrillated. Here is a case of ECMO defibrillation with near shark fin that was due to proximal LAD occlusion.
Written by Kaley El-Arab MD, edits by Pendell Meyers and Stephen Smith A 61-year-old male with hypertension and hyperlipidemia presented to the emergencydepartment for chest tightness radiating to the back of his neck that has been intermittent for the past day or two. It is true this ECG does not meet STEMI criteria (there is 1.0
Upon arrival to the emergencydepartment, a senior emergency physician looked at the ECG and said "Nothing too exciting." She was defibrillated and resuscitated. This has resulted in an under-representation of STEMI MINOCA patients in the literature. From Gue at al. Circulation. 2017;135(16):1490–3.
He was resuscitated with chest compressions and defibrillation and 1 mg of epinephrine. He arrived in the emergencydepartment hemodynamically stable. Thus, this patient had increased ST elevation (current of injury) superimposed on the ST elevation of LVH and simulating STEMI. His initial ECG is shown here.
STEMI , ST-segment elevation acute myocardial infarction ). 1 Initial diagnosis of STEMI ECG Management Recommendation Level of evidence A 12-lead ECG should be interpreted immediately (within 10 minutes) at first medical contact. I B ECG monitoring should start immediately and a defibrillator must be ready.
She was never seen to be in ventricular fibrillation and was never defibrillated. Note that they finally have laid to rest the new or presumably new LBBB as a criteria for STEMI. Note that they finally have laid to rest the new or presumably new LBBB as a criteria for STEMI. BP gradually rose. Kurkciyan et al.
Submitted and written by Megan Lieb, DO with edits by Bracey, Smith, Meyers, and Grauer A 50-ish year old man with ICD presented to the emergencydepartment with substernal chest pain for 3 hours prior to arrival. The screening physician ordered an EKG and noted his ashen appearance and moderate distress. Triage EKG: What do you think?
After epinephrine, atropine, and defibrillation x 2, there was a return of pulses. There is ST depression in II, III, and aVF that is concerning for reciprocal depression from high lateral STEMI in aVL, where there is some ST elevation. She collapsed and 911 was called; she was found pulseless. Exact rhythm during arrest is uncertain.
She presented to the EmergencyDepartment at around 3.5 Soon after the witnessed occlusion, the patient suffered ventricular fibrillation arrest, from which he was immediately resuscitated with 1 defibrillation. The chest pain was described as severe pressure radiating to both shoulders. Vital signs were within normal limits.
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