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. There is evidence that taking those patients with ROSC and EKG showing STEMI directly for angiography +/- angioplasty is associated with positive patient-oriented outcomes.
REBEL EM
SEPTEMBER 14, 2023
Revascularization of the culprit lesion remains one of the few established treatments though there are numerous other unproven modalities including extracorporeal life support (ECLS). Extracorporeal Life Support in Infarct-Related Cardiogenic Shock. Extracorporeal Life Support in Infarct-Related Cardiogenic Shock.
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The Skeptics' Guide to EM
FEBRUARY 2, 2019
In the 2015 AVOID study there was some suggestion of increased MI size in the group of STEMI patients that received oxygen at 8 L/min compared to a room air control group. This study expands upon that investigation to patients with other conditions as well.
ESO
JANUARY 19, 2024
Working towards better detection Another area ESO has identified as an opportunity to improve is how EMS services detect a possible STEMI or NSTEMI with a 12-lead EKG. Currently, conventional EMS education tends to center symptoms of a STEMI or NSTEMI for males as “typical” and females as “atypical.”
EMDocs
JANUARY 8, 2024
Editorial Comment : Yes to PCI after arrest with STEMI on ECG. Emergent coronary angiography is not recommended over delayed or selective strategy if there is no STEMI, shock, electrical instability, evidence of significant myocardial injury, and ongoing ischemia. COR 3, No benefit, LOE B-R. Circulation. 2023 Dec 18. doi: 10.1161/CIR.0000000000001194.
Dr. Smith's ECG Blog
MAY 19, 2020
She was unable to be defibrillated but was cannulated and placed on ECMO in our Emergency Department (ECLS - extracorporeal life support). This is a troponin I level that is almost exclusively seen in STEMI. So this is either a case of MINOCA, or a case of Type II STEMI. Troponin I rose to 44.1
Dr. Smith's ECG Blog
NOVEMBER 12, 2020
He was started on Extracorporeal Life Support ("VA ECMO") Here is the ECG on ECMO: Very low voltage On Day 3, the EF recovered (that seems quick!) 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. Angiogram was negative.
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