Dr. Smith's ECG Blog

MARCH 1, 2023

In the ED he received methylprednisolone, diphenhydramine, and epinephrine for possible anaphylaxis. Shortly after receiving epinephrine, the patient developed new leg cramps and chest pain. A "STEMI alert" was called and soon cancelled. The chest pain was described as sharp and radiated to both arms.

Allergic Reaction 52

Allergic Reaction E-9-1-1 Epinephrine Coronary 52

Dr. Smith's ECG Blog

JULY 21, 2024

The ECG shows obvious STEMI(+) OMI due to probable proximal LAD occlusion. Epinephrine infusion was begun. The patient in today’s case is a previously healthy 40-something male who contacted EMS due to acute onset crushing chest pain. The below ECG was recorded. Subsequent PCI of the LMCA and LAD was performed.

Defibrillator 131

Defibrillator Coronary ALS STEMI 131

Dr. Smith's ECG Blog

OCTOBER 20, 2013

With ventilations and epinephrine, she regained a pulse. 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. A middle-age woman with h/o hypertension was found down by her husband.

STEMI 52

STEMI Coronary ACS Emergency Department 52

Dr. Smith's ECG Blog

JANUARY 19, 2020

There is STE in III and aVF which does not meet STEMI criteria due to insufficient STE in lead aVF. The interventionalists insisted that the ECGs did not meet STEMI criteria and cancelled the activation, stating that they would consider urgent cath after further stabilization. This is an obvious inferoposterior OMI. mm STE with 9.5

E-9-1-1 52

E-9-1-1 STEMI ED EMS 52

Dr. Smith's ECG Blog

OCTOBER 28, 2013

Fine ventricular fibrillation She received 2 mg epinephrine, 150 mg amiodarone and underwent chest compressions with the LUCAS device. The last section is a detailed discussion of the research on aVR in both STEMI and NonSTEMI. She arrived in the ED 37 minutes after 911 was called, with continuing CPR. see below).

Defibrillator 52

Defibrillator ACS CPR STEMI 52

Dr. Smith's ECG Blog

NOVEMBER 12, 2020

He underwent CPR, and regained a pulse after epinephrine, with an organized narrow complex rhythm at 140, but still with severe shock. In a series of 18 patients with COVID and ST elevation, 8 were diagnosed with STEMI, 6 of whom had an angiogram and it showed obstructive coronary disease. He was intubated and then went pulseless.

E-9-1-1 52

E-9-1-1 STEMI Coronary ALS 52

Dr. Smith's ECG Blog

NOVEMBER 19, 2016

Clinical Course The paramedic activated a “Code STEMI” alert and transported the patient nearly 50 miles to the closest tertiary medical center. 2 The astute paramedic recognized this possibility and announced a CODE STEMI. Look at the aortic outflow tract. What do you see? Answer below in the still shot.

Coronary 40

Coronary ACS ALS STEMI 40

Dr. Smith's ECG Blog

OCTOBER 10, 2022

On epinephrine and norepinephrine drips." He had multiple cardiac arrests with ROSC regained each time. Endotracheal tube re-intubation was confirmed multiple times, bilateral breath sounds, yet O2 saturation remained in the 50s and 60s. CT angiogram showed extensive saddle pulmonary embolism.

ACS 52

ACS CPR CAD Heart Attack 52

Dr. Smith's ECG Blog

DECEMBER 22, 2010

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.

STEMI 40

STEMI Defibrillator Epinephrine Emergency Department 40

Dr. Smith's ECG Blog

FEBRUARY 20, 2025

Resuscitated with chest compressions, epinephrine. A 12-lead was recorded, showing "STEMI," but is unavailable. including epinephrine, and there was ROSC. This is what the providers in the ED understood on patient arrival: Patient called 911 for syncope, then had witnessed PEA arrest after medics arrived. Not a shockable rhythm.

STEMI 89

STEMI Paramedic E-9-1-1 Epinephrine 89

EMDocs

OCTOBER 29, 2024

EPINEPHRINE-INUDCED SHOCK: LEFT VENTRICULAR OUTFLOW TRACT OBSTRUCTION ON VASOPRESSORS. m/s)—problematic and elevated > 50 mm Hg (2.5 m/s)—problematic and elevated > 50 mm Hg (2.5 Left ventricular outflow tract gradient variability in hypertrophic cardiomyopathy. Clin Cardiol. 2009;32(7):397-402. doi:10.1002/CLC.20594

E-9-1-1 98

E-9-1-1 ICU Epinephrine EMS 98

FOAMfrat

DECEMBER 4, 2024

In the EMS setting, the most common cardiogenic shock patient is most likely a STEMI. In right-sided shock (inferior STEMIs with +RVI), the LV is underfed due to a poorly functioning RV that can’t pump blood across the pulmonary vasculature. As a result of the increased LVEDP, CPP falls. mcg/kg/min.

Coronary 64

Coronary STEMI Epinephrine Critical Care 64