Document Overdose STEMI 
ACEP Now
OCTOBER 3, 2023
This document is an update of guidelines first published in 2000, and then updated in 2007. Confounders to the GCS such as seizure and post-ictal phase, ingestions and drug overdose, as well as medications administered in the prehospital setting that impact GCS score should be documented. 2019;154(7):e191152.
Dr. Smith's ECG Blog
JULY 21, 2024
The ECG shows obvious STEMI(+) OMI due to probable proximal LAD occlusion. In both tracings — an exceedingly fast PMVT is documented. These are also the most commonly reported findings in toxic overdoses with ventricular arrhythmias being reported as the leading cause of death. The below ECG was recorded.
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Dr. Smith's ECG Blog
JUNE 20, 2018
The medicine note documents that the patient had worsening pain with lying flat and relief with leaning forward. See this case: Pericarditis, or Anterior STEMI? I n the intervening 3 hours, new Q-waves have developed in leads V3 and V4, and deepened in V5 and V6. There was no history of preceding viral symptoms. Confirmation bias?
Dr. Smith's ECG Blog
NOVEMBER 30, 2019
This is pathognomonic of hyperkalemia (I suppose it could be due to a massive overdose of a sodium channel blocking drug, maybe). Document in the patient's chart that rapid infusion is intentional in response to life-threatening hypokalemia." to greatly decrease risk (although in STEMI, the optimal level is about 4.0-4.5
Dr. Smith's ECG Blog
DECEMBER 31, 2024
The note documents that the first view of the LCX showed 99%, TIMI 2 flow, but then (before intervention) was seen to fully occlude in real time (100%, TIMI 0). Final Diagnosis: "STEMI" (of course, as you can see in the ECGs above, this is not true, by definition this was NSTEMI. She was emergently transferred to a PCI center.
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