EMDocs

JANUARY 16, 2024

The patient received 1 mg of epinephrine IV x2 with conversion of his rhythm to ventricular fibrillation (VF) for which he was defibrillated twice in the field. The patient is moved over to the stretcher and connected to the monitors and defibrillator. What would your next steps be? His point-of-care labs return with a potassium of 3.4

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Defibrillator CPR Epinephrine Life Support 109

Dr. Smith's ECG Blog

JULY 21, 2024

He required multiple defibrillations within a period of a few hours. This time, the arrhythmia did not spontaneously terminate — but rather degenerated to VFib, requiring defibrillation. Some episodes of PMVT would terminate spontaneously — but on many occasions, the PMVT degenerated to VFib, requiring defibrillation.

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Defibrillator Coronary ALS STEMI 131

EMDocs

JANUARY 3, 2024

As you order a dose of intravenous diuretic, you wonder what device they have and what information it can give. 2-4 Chest impedance can be measured by implanted cardioverter-defibrillators (ICDs) and implanted cardiac resynchronization defibrillators (CRT-D) inserted for other indications.

Defibrillator 113

Defibrillator Allergic Reaction ED ALS 113

REBEL EM

JUNE 1, 2023

Known cardiac defibrillator. The authors did not give detailed information on why patients were excluded particularly in the SDCT enrollment period when the vast majority of ROSC patients were not included. Indication for emergency invasive coronary angiography or had coronary angiography within 1 hour of arrival.

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Coronary Defibrillator CPR ALS 145

Dr. Smith's ECG Blog

OCTOBER 18, 2023

I sent the top ECG to Dr Smith with no information and without the baseline ECG. She spontaneously converted (Defibrillation was not performed). Most such rhythms in the setting of ischemia are VF and will not convert without defibrillation. Is this an inferior OMI with reciprocal T wave inversion i aVL?

Defibrillator 122

Defibrillator Advanced Life Support Coronary Life Support 122

Utah's Paramedic and EMS Academy

OCTOBER 23, 2023

Upon arrival, you quickly assess the situation and spring into action, working to save a man's life through CPR and defibrillation. During the briefing, the team reviews essential information from the previous shift's reports, including patient details, medications administered, and potential ongoing issues.

EMT 52

EMT EMT Emergency Medical Technician Defibrillator 52

Dr. Smith's ECG Blog

OCTOBER 4, 2010

He was resuscitated with chest compressions and defibrillation and 1 mg of epinephrine. ACS would be highly unusual in a young athlete, and given the information on his race bib, one must first suspect that the abnormal ST elevation is due to demand ischemia, not ACS. This young male had ventricular fibrillation during a triathlon.

ACS 52

ACS Defibrillator Epinephrine STEMI 52

The Overrun Podcast

MAY 23, 2024

He also highlights the potential of technology, such as ultrasound and sending real-time information to the trauma team. Takeaways Advances in medical resuscitation have focused on basic life support (BLS) interventions, such as compression-only CPR and early defibrillation.

CPR 52

CPR BLS EMS Life Support 52

Dr. Smith's ECG Blog

APRIL 6, 2018

EMS report was that the patient had unknown down time with unwitnessed arrest, found initially in VFib arrest, defibrillated x1 followed by PEA arrest alternating with asystolic arrest during transport. Upon closer inspection, the defibrillator's monitor had assigned a spike for every large T wave as well as every QRS complex.

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Defibrillator ICU EMS Plasma 52

EMT Training Station

FEBRUARY 11, 2024

This rapport can also provide valuable information about the incident, aiding in our assessment and treatment decisions. We use portable electrocardiogram (ECG) machines to monitor heart rhythms and are equipped to administer life-saving interventions like defibrillation or medication administration to stabilize the heart rhythm.

EMT 98

EMT EMT Emergency Medical Technician First Aid 98

REBEL EM

SEPTEMBER 19, 2022

Background: There are only two interventions that have been proven in the medical literature to improved outcomes in cardiac arrest: high-quality CPR and early defibrillation. This appears to be data dredging or “seeking more information from a data set than it actually contains.” Head Up (HUP) CPR may be the next critical improvement.

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CPR Defibrillator EMS Epinephrine 52

EMDocs

SEPTEMBER 23, 2023

Patients with Brugada syndrome should have a prompt cardiology consultation for consideration of implantable defibrillator placement due to the high risk of sudden cardiac death. The demographic information in the above explanation follows AMA Manual of Style terminology and may not match the language used in the references.

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E-9-1-1 EMS ALS Defibrillator 105

Don't Forget the Bubbles

JULY 26, 2023

Are we focused on the immediate presentation and therefore not using all the possible information to hone in on the possibilities? Based on the information from the rhythm strip and the response to DC cardioversion, this child has had a VF arrest. All were examined and 98% had an ECG. A 5 year old girl presents feeling ‘butterflies’.

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ALS ED OR CPR 98

First Responders Foundation

JULY 31, 2024

Similarly, funds can help purchase new defibrillators for paramedics, ensuring they have access to reliable equipment during critical life-saving moments. For more information, visit First Responders Foundation , or contact us.

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First Responder Public Safety Mental Health Services Firefighter 52

Dr. Smith's ECG Blog

OCTOBER 3, 2017

I sent this ECG with no clinical information to Dr. Smith. After the second defibrillation the patient had an organized rhythm: Bradycardic escape/agonal rhythm, with large ST deviations. He replied: "If acute chest discomfort, then this is likely an acute proximal LAD occlusion STE in V2 with a Q-wave Subtle ST depression in III, aVF.

CPR 52

CPR Defibrillator STEMI ED 52

Dr. Smith's ECG Blog

SEPTEMBER 21, 2020

I was texted these ECGs by a recent residency graduate after they had all been recorded, along with the following clinical information: A 50-something with no cardiac history, but with h/o Diabetes, was doing physical work when he collapsed. Here is the initial ED ECG: This is pretty obviously and inferior posterior OMI, right?

STEMI 52

STEMI Defibrillator ED ACS 52

Dr. Smith's ECG Blog

SEPTEMBER 20, 2018

Remember that the ECG reports what is happening to the myocytes , then you must use that information to make inferences about what the patient needs. This ECG was presumably performed during the patient's prior MI, most likely during a period of reperfusion or after PCI of the LAD (this information is not available).

STEMI 52

STEMI Coronary ACS Defibrillator 52

NCOAE

MARCH 8, 2021

covering prehospital medical providers — recognizes three levels of EMTs/paramedics: EMT: EMTs provide non-invasive life-support services, such as cardiopulmonary resuscitation (CPR), administering oxygen, performing automated external defibrillation, basic and advanced airway management, and administering authorized medications.

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EMT EMT Emergency Medical Technician AEMT 52

Paramedic Training Spot

NOVEMBER 29, 2021

You must also pass your practical examinations, which can include things like HARE traction splints, manual airway management, or proper CPR and AED (Automated External Defibrillator) use. Those who have been on an ambulance for the past 20 years are a vault of information-listen to their stories, their triumphs, and their failures.

EMT 52

EMT EMT EMR Emergency Medical Technician 52

Dr. Smith's ECG Blog

FEBRUARY 13, 2023

I sent the first ECG to Dr. Meyers without any information, and he replied, “good one. But these ECGs were from the same patient: #1 on paramedic arrival and #2 thirty minutes later. The patient's LAD was occluded from the start even though the first ECG didn’t manifest STEMI criteria. Will be missed easily.”

STEMI 52

STEMI Paramedic Coronary ALS 52

Dr. Smith's ECG Blog

JANUARY 23, 2023

After reviewing the available information, cardiology did not feel that the patient warranted emergent PCI and recommended heparin infusion and cardiac catheterization the following morning. When the ICD was finally interrogated, the syncopal events and shocks correlated with two VF events that were defibrillated successfully.

ACS 52

ACS Coronary Defibrillator STEMI 52

Dr. Smith's ECG Blog

OCTOBER 10, 2022

It was reportedly a PEA arrest; there was no recorded V Fib and no defibrillation. I sent it to 2 of my ECG nerd colleagues with no clinical information whatsoever, who instantly said: "Looks like afib with subendocardial ischemia and right heart strain pattern." "I CPR was initiated immediately.

ACS 52

ACS CPR CAD Heart Attack 52

Paramedic Training Spot

NOVEMBER 29, 2021

For more information about becoming a better EMT, check out EMS World, a website that creates content for practical healthcare education and improves patient care, outcomes, and lives. Distinguish Between “Code” and a “Non-Code.” The fourth tip is to remember that you are not going to save everyone.

EMT 52

EMT EMT Paramedic Ambulance 52

Dr. Smith's ECG Blog

NOVEMBER 30, 2022

She was defibrillated and resuscitated. Optical coherence tomography, due to its high resolution, may provide additional information [ 10,13 ]. Upon arrival to the emergency department, a senior emergency physician looked at the ECG and said "Nothing too exciting."

Emergency Department 52

Emergency Department E-9-1-1 Coronary STEMI 52

ACEP Now

OCTOBER 28, 2024

Caring for critically ill patients with limited information requires snap assessments and judgements for timely resuscitation and efficient emergency department throughput. He was defibrillated twice and received 2 doses of epinephrine, with return of spontaneous circulation. Sound familiar? This is the essence of emergency medicine.

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Emergency Department Defibrillator Epinephrine EMS 52

Dr. Smith's ECG Blog

DECEMBER 22, 2010

After epinephrine, atropine, and defibrillation x 2, there was a return of pulses. For more information, see chapter 28 of Smith's " The ECG in Acute MI." A 65 yo woman had felt ill for 36 hours, had seen her MD but without undergoing a cardiac evaluation. She collapsed and 911 was called; she was found pulseless. Plummer D et al.

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STEMI Defibrillator Epinephrine Emergency Department 40

Dr. Smith's ECG Blog

FEBRUARY 17, 2023

Treatment is by ICD ( implantable cardioverter defibrillator ). As can be seen from the above cited QTc intervals — this demographic information is relevant to today’s case! The disorder is rare — but it takes on importance as a potential cause of atrial and ventricular arrhythmias, including cardiac arrest.

STEMI 52

STEMI Defibrillator OR ED 52

Dr. Smith's ECG Blog

MARCH 8, 2025

Several 200 J shocks did not terminate the VF, so a second defibrillator was applied for double sequential defibrillation with 400 J. She was defibrillated perhaps 25 times. Propranolol versus Metoprolol for treatment of electrical storm in patients with implantable cardioverter-defibrillator. SanzRuiz, R., Solis, J., &

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E-9-1-1 OR Defibrillator Coronary 75

Dr. Smith's ECG Blog

DECEMBER 27, 2024

The submitter started the patient on amiodarone and arranged implantation of a defibrillator. == MY Comment , by K EN G RAUER, MD ( 12/27 /2024 ): == Superb discussion by Dr. Frick in today's case, that highlights a series of important points regarding the ECG recognition of stable VT ( V entricular T achycardia ).

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Coronary Defibrillator ACS ED 121

FOAMfrat

DECEMBER 31, 2024

With that being said, the manufacturers say that CPR, medications, Defibrillation, Cardioversion, and Anything you would normally do are OKAY. These people can direct resuscitation efforts based on the information you provide them (i.e. We still defibrillate ventricular fibrillation just as we would any other patient.

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CPR Defibrillator Emergency Department Emergency Transportation 64

Peter Canning

APRIL 3, 2025

The dispatcher then takes down some preliminary information before kicking the call to the ambulance company. But if it was a cardiac arrest with a patient requiring CPR and defibrillation, it may not have been a medically sound idea. Does it start when 911 is dialed or when the ambulance company is notified? How much for EMS?

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Ambulance First Responder EMS Defibrillator 52

ACEP Now

OCTOBER 29, 2024

He was defibrillated twice and received two doses of epinephrine, with return of spontaneous circulation. He underwent placement of a dual chamber, implantable, cardioverter-defibrillator (ICD) placement on hospital day 5. There was no family history of syncope or sudden death. Figure 1: The EMS rhythm strip. Click to enlarge.)

E-9-1-1 52

E-9-1-1 Defibrillator ALS Epinephrine 52