Emergency Medicine Cases

JANUARY 28, 2020

And for STEMI too. The post JJ 16 Heparin for ACS and STEMI appeared first on Emergency Medicine Cases. We’re expected to routinely give heparin for all these NSTEMI and unstable angina patients with any ischemic changes seen on the ECG, right? But should we?

ACS 130

ACS STEMI OR EMS 130

Emergency Medicine Cases

OCTOBER 22, 2019

Can you identify which were early repolarization and which were anterior STEMI? The post ECG Cases 2: Early Repolarization or Anterior STEMI? In this ECG Cases blog we present ECGs from 7 patients who presented with chest pain and mild anterior ST elevation. appeared first on Emergency Medicine Cases.

STEMI 130

STEMI OR EMS 130

Emergency Medicine Cases

JANUARY 17, 2023

In this ECG Cases blog we look at 9 patients with possible transient STEMI and discuss pitfalls and pearls in ECG interpretation and management. The post ECG Cases 39 – Transient STEMI Pitfalls and Pearls appeared first on Emergency Medicine Cases.

STEMI 130

STEMI EMS 130

Emergency Medicine Cases

MARCH 10, 2020

10 patients presented with the "STEMI-equivalent" ST elevation in aVR with diffuse ST depression. The post ECG cases 7: ST elevation in aVR, STEMI-equivalent? Which had acute coronary occlusion? Jesse McLaren guides us through the differential diagnosis of ST elevation in aVR with diffuse ST depression in this ECG Cases blog.

STEMI 130

STEMI Coronary EMS 130

REBEL EM

SEPTEMBER 28, 2023

Background: Primary PCI is the recommended reperfusion strategy in patients with STEMI and should be initiated within 2 hours after first medical contact. In non-PCI-capable hospitals this goal is not always achievable due to delays in transfer. In these cases, thrombolysis is recommended to improve morbidity and mortality. Primary PCI: 95.7%

STEMI 138

STEMI Allergic Reaction Coronary Ambulance 138

Emergency Medicine Cases

JUNE 6, 2023

We discover that for STEMI/OMI vs subendocardial ischemia, we should look for STEMI(-)OMI, subacute OMI, and OMI in the presence of LBBB and RBBB, and consider the differential for diffuse ST depression with reciprocal ST elevation in aVR.

STEMI 266

STEMI EMS 266

Emergency Medicine Cases

SEPTEMBER 21, 2021

Jesse McLaren explains 'Late STEMI' and how reperfusion strategies should not be based on time of symptom onset. The post ECG Cases 25: ‘Late STEMI’ – How acute is the coronary occlusion? In this ECG Cases blog we look at 10 patients with potentially ischemic symptoms. appeared first on Emergency Medicine Cases.

Coronary 130

Coronary STEMI EMS 130

Dr. Smith's ECG Blog

SEPTEMBER 12, 2024

Written by Pendell Meyers A man in his 40s called EMS for acute chest pain that awoke him from sleep, along with nausea and shortness of breath. Learning Points: Currently by definition, there is unfortunately no such thing as a formal diagnosis of STEMI or STEMI criteria in the setting of RBBB and LAFB.

STEMI 121

STEMI EMS ACS ED 121

Emergency Medicine Cases

JULY 18, 2023

The post EM Quick Hits 50 Normal Unenhanced CT Renal Colic DDx, Perichondritis, Magnesium in Pediatric Asthma, Steroids for Pneumonia, OMI Cath Lab Activation appeared first on Emergency Medicine Cases.

EMS 240

EMS ACS STEMI 240

EMDocs

DECEMBER 11, 2023

Traditionally, emergency providers looked for signs of ST-segment elevation myocardial infarction (STEMI) to indicate the need for intervention. Emergency physicians have recognized for some time that there are many occlusions of the coronary arteries that do not present with classic STEMI criteria on the ECG.

STEMI 119

STEMI Coronary Emergency Department OR 119

Emergency Medicine Cases

MAY 10, 2023

In this ECG Cases blog we look at 10 cases of patients with chest pain, including false positive STEMI, false negative STEMI, and other causes to help hone your ECG interpretation skills in time-sensitive cases where those very ECG skills might save a life.

STEMI 130

STEMI EMS 130

Peter Canning

JANUARY 27, 2025

For instance, there was no protocol for stroke or STEMI. At some point along the way we had protocols for spinal motion restriction, alcohol withdrawal, stroke and STEMI, CPAP, and termination of cardiac arrest resuscitation on scene. The book was approved by the two largest hospitals in Hartford. Paramedics didnt do 12-lead ECGs then.

Allergic Reaction 90

Allergic Reaction Naloxone Paramedic STEMI 90

Emergency Medicine Cases

AUGUST 8, 2023

We consider electrolyte disturbances and look for ECG signs of hyperkalemia or hypokalemia/hypomagnesemia, and we consider the differential of diffuse ST depression with reciprocal ST elevation in aVR, and false positive STEMI. The post ECG Cases 44 ECG Interpretation in Epigastric pain, Vomiting appeared first on Emergency Medicine Cases.

STEMI 229

STEMI OR EMS 229

Pulsara

JANUARY 25, 2024

Metropolitan Emergency Medical Services (MEMS) is a public, non-profit EMS entity serving Little Rock, Arkansas, and its surrounding counties. In 2020, MEMS adopted Pulsara to improve communication with area hospitals for time-sensitive emergencies such as stroke, STEMI, and trauma. MEMS transports around 77,000 patients each year.

Emergency Medical Services 115

Emergency Medical Services EMS STEMI Emergency Department 115

Emergency Medicine Cases

MAY 10, 2023

In this ECG Cases blog we look at 10 cases of patients with chest pain, including false positive STEMI, false negative STEMI, and other causes to help hone your ECG interpretation skills in time-sensitive cases where those very ECG skills might save a life.

STEMI 100

STEMI EMS 100

REBEL EM

JULY 5, 2023

If it looks and feels like a STEMI clinically, get serial ECGs and consult Cardiology immediately. Post Created By: William Caputo MD Post Peer Reviewed By: Anand Swaminathan MD, MPH (Twitter @EMSwami ) The post REBEL Core Cast 104.0 – Subtle ECGs in Acute Coronary Occlusion appeared first on REBEL EM - Emergency Medicine Blog.

Coronary 139

Coronary STEMI EMS ED 139

EMergucate

MAY 25, 2016

Systematically developed statements to assist Dr and patient e.g. trauma calls, STEMI pathways, drug Pros Use of effective treatment Consistent … Continue reading →

EMS 100

EMS STEMI 100

ESO

APRIL 19, 2024

From April 2-5, the top fire services and EMS industry thought leaders and data analysts gathered at Wave 2024 to share what trends they’re forecasting for both fields and how they’re enacting change within their own organizations through the power of data-driven insights. Data impacts every aspect of duties, from shifts start to end.

MIH 105

MIH EMS Paramedic Firefighter 105

EMS 12-Lead

AUGUST 14, 2022

EMS personnel found him seated on a bench, uncomfortable, but without gross distress. A third, and final, EMS 12 Lead ECG was recorded: The precordial ST segments (even Leads I/aVL, as well) have reverted to a dramatically depressed state. it has been subsequently deemed a STEMI-equivalent.

MICU 130

MICU STEMI CAD Coronary 130

Dr. Smith's ECG Blog

JUNE 7, 2024

Obvious infero-postero-lateral STEMI(+)OMI, regardless of context Now let’s put them in order: what was the sequence? Now let’s look at the actual sequence, with the addition of clinical context, and see how the patient was managed: The patient received aspirin from EMS and arrived at triage painfree (ECG #1).

STEMI 112

STEMI Coronary OR EMS 112

Dr. Smith's ECG Blog

JULY 9, 2024

His family started CPR and called EMS, who arrived to find him in ventricular fibrillation. 15 minutes after EMS arrival, after at least 6 defibrillations, the patient achieved sustained ROSC. Written by Pendell Meyers A man in his 50s was found by his family in cardiac arrest of unknown duration.

Defibrillator 116

Defibrillator STEMI CPR EMS 116

Dr. Smith's ECG Blog

JULY 7, 2024

Written by Jesse McLaren A previously healthy 60 year old developed exertional chest pain with diaphoresis, and called EMS. Here’s the EMS ECG, digitized with PM cardio. First trop was 7,000ng/L (normal 25% of ‘Non-STEMI’ patients with delayed angiography have the exact same pathology of acute coronary occlusion.

STEMI 66

STEMI Coronary ALS OR 66

Emergency Medicine Cases

DECEMBER 8, 2020

In this month's EM Quick Hits podcast: Anand Swaminathan on lateral canthotomy, Emily Austin on pediatric cannabis poisoning, Reuben Strayer on an approach to hyperthermia, Brit Long on diagnosis and management of malignant otitis externa, Jesse McLaren on ECG diagnosis of occlusion MI in patients with BBB and Peter Brindley on prone CPR.

CPR 130

CPR EMS STEMI 130

Emergency Medicine Cases

JUNE 21, 2022

In this ECG Cases blog we review 8 cases of patients with prehospital ECGs and explore prehospital ECGs for diagnosing STEMI, Occlusion MI, false STEMI, code STEMI, dynamic ischemic changes, truncated voltages. Can you avoid the pitfalls and spot the pearls that help to make the diagnosis?

STEMI 130

STEMI Paramedic EMS 130

Dr. Smith's ECG Blog

AUGUST 11, 2024

While STEMI negative, the ECG is diagnostic of proximal LAD occlusion. Transient STEMI” are often managed like non-STEMI with delayed angiography, which is very risky. This case is an example of the steps we can all take in daily practice as the paradigm shifts from STEMI to OMI.

STEMI 100

STEMI Paramedic Coronary EMS 100

Dr. Smith's ECG Blog

NOVEMBER 29, 2023

Written by Pendell Meyers Two adult patients in their 50s called EMS for acute chest pain that started within the last hour. Both cases had an EMS ECG that was transmitted to the ED physician asking "should we activate the cath lab?" He diagnosed anterior "STEMI" and activated the cath lab. What do you think? But he did well.

OR 125

OR STEMI EMS ED 125

Emergency Medicine Cases

DECEMBER 20, 2022

In patients with chest pain + ST elevation, consider false positive STEMI including early repolarization, LVH and Brugada-pattern. In patients with cocaine chest pain who are STEMI negative, beware STEMI(-)OMI including subtle ST elevation, hyperacute T waves, reciprocal change, and refractory ischemia.

STEMI 130

STEMI EMS 130

Dr. Smith's ECG Blog

APRIL 18, 2024

I sent this to the Queen of Hearts So the ECG is both STEMI negative and has no subtle diagnostic signs of occlusion. Non-STEMI guidelines call for “urgent/immediate invasive strategy is indicated in patients with NSTE-ACS who have refractory angina or hemodynamic or electrical instability,” regardless of ECG findings.[1]

STEMI 121

STEMI Coronary ALS CAD 121

ECG Medical Training

SEPTEMBER 4, 2016

EMS was called to evaluate a male patient in his 60s with a chief complaint of chest pain. Onset: Gradual while walking Provoke: Initially the pain felt better with rest Quality: Described as a dull ache Radiate: The pain radiates to the back Severity: 7/10 Time: 3 hours He states that he feels nauseated and vomited x2 prior to EMS arrival.

STEMI 52

STEMI Paramedic Coronary Emergency Department 52

Prehospital Emergency Care Podcast

JUNE 29, 2022

The PEC Podcast with host Dr. Maia Dorsett brings you our Deep Dive Series with: Daniel Joseph MD Kevin Burns EMT-P, PA-C Aman Shah MD who discuss their manuscript: STEMI Equivalents and Their Incidence during EMS Transport Click here to download today! As always THANK YOU for listening.

STEMI 52

STEMI EMT EMT EMS 52

Emergency Medicine Cases

FEBRUARY 11, 2020

In this ECG Cases blog we look at 8 patients with potentially ischemic symptoms, none of whom had STEMI on the 12 lead ECG. Which had occlusion MI? The post ECG cases 6: Posterior MI – Still Under-recognized appeared first on Emergency Medicine Cases.

STEMI 130

STEMI EMS 130

Dr. Smith's ECG Blog

FEBRUARY 22, 2024

Written by Pendell Meyers A woman in her 30s called EMS for acute symptoms including near-syncope, nausea, diaphoresis, and abdominal pain. EMS arrived and found her to appear altered, critically ill, and hypotensive. EMS reportedly gave 4 grams of calcium (unknown whether CaCl or gluconate) and 50 mEq of sodium bicarbonate.

EMS 140

EMS STEMI ED OR 140

Emergency Medicine Cases

MAY 18, 2020

Seven patients with ischemic symptoms, none meeting STEMI criteria but all identified by a specific pattern of first diagonal branch occlusion are explored in this ECG Cases blog with Jesse MacLaren who also explains The South African Flag Sign.

STEMI 130

STEMI EMS 130

Dr. Smith's ECG Blog

JUNE 21, 2023

EMS was called, and they recorded the following ECG on scene at 13:16: What do you think? In this medical system, the EMS provider can then be routed to the ED or to a type of urgent care facility that is open 24 hrs/day and staffed by a primary care provider. In this case, the EMS provider was routed to the urgent care facility.

STEMI 98

STEMI Coronary Defibrillator EMS 98

EMS 12-Lead

APRIL 8, 2022

He reported to EMS a medical history of GERD only. BP 142/100 HR 90 RR 16 (BBS CTA) SpO2 99 (RA) Dstick 110 My colleagues noted the ST-depression in the respective leads, as well, and STEMI activated to the nearest PCI center. 1] Here is the admitting ED ECG after cancellation of Code STEMI. However, in this context (i.e.

STEMI 130

STEMI ALS Coronary CAD 130

Emergency Medicine Cases

SEPTEMBER 15, 2020

LVH produces secondary repolarization abnormalities that can mimic STEMI. Signs of occlusion MI in patients with LVH include: new Q waves/loss of R waves, disproportionate and dynamic ST elevation (or ST depression from posterior MI), and hyperacute T waves.

STEMI 130

STEMI Coronary OR EMS 130

The Skeptics' Guide to EM

SEPTEMBER 11, 2021

Guest Skeptic: Dr. Stephen Meigher is the EM Chief Resident training with the Jacobi and Montefiore Emergency Medicine Residency Training Program. Guest Skeptic: Dr. Stephen Meigher is the EM Chief Resident training with the Jacobi and Montefiore Emergency Medicine Residency Training Program. The TOMAHAWK Investigators.

EMR 130

EMR Coronary Defibrillator Life Support 130