Defibrillator Paramedic STEMI 
EMS 12-Lead
MARCH 19, 2023
David Didlake Acute Care Nurse Practitioner Firefighter / Paramedic (Ret) @DidlakeDW Expert contribution by Dr Robert Herman @RobertHermanMD @PowerfulMedical (Chief Medical Officer) An adult male called 911 for new-onset epigastric burning. To which the lead paramedic replied, “Not cardiac; his symptoms are atypical. Is this OMI?
The Skeptics' Guide to EM
SEPTEMBER 11, 2021
The paramedics achieve return of spontaneous circulation (ROSC) after CPR, advanced cardiac life support (ALCS), and Intubation. 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.
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Dr. Smith's ECG Blog
FEBRUARY 13, 2023
Written by Jesse McLaren Two 70 year olds had acute chest pain with nausea and shortness of breath, and called paramedics. There’s inferior ST depression which is reciprocal to subtle lateral convex ST elevation, and the precordial T waves are subtly hyperacute – all concerning for STEMI(-)OMI of proximal LAD. Who needs the cath lab?
Dr. Smith's ECG Blog
FEBRUARY 25, 2009
RBBB in acute STEMI has a very high mortality. The paramedics activated the cath lab from the field. But here there is a large degree of ST elevation in V2-V6, I, and aVL.
Dr. Smith's ECG Blog
NOVEMBER 30, 2022
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. She was defibrillated and resuscitated. Learning Points: 1. From Gue at al.
Dr. Smith's ECG Blog
FEBRUARY 20, 2025
Here is the written paramedic report available after all the events were over: Patient was seen by witnesses to become unresponsive. A 12-lead was recorded, showing "STEMI," but is unavailable. Moreover, when someone has immediate resuscitation of an arrest witnessed by paramedics, they rarely have a GCS of 3 (deep coma).
Dr. Smith's ECG Blog
APRIL 9, 2025
The paramedics diagnosis was "Possible Anterolateral STEMI." We rapidly defibrillated her, and with return of normal sinus rhythm. Several minutes later the patient developed V-fib again > 200J defibrillation with return to NSR. More proof that a huge STEMI may have normal or near normal initial troponin.
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