Dr. Smith's ECG Blog

JUNE 28, 2018

This ECG (ECG #3) was recorded immediately after the last episode of pain spontaneously resolved. Angiographic and clinical characteristics of patients with unstable angina showing and ECG pattern indicating critical narrowing of the proximal LAD coronary artery. Here is the first post-cath ECG (ECG #4).

EKG/ECG 52

EKG/ECG Burns Research Outcomes 52

Dr. Smith's ECG Blog

SEPTEMBER 12, 2023

What do you notice about the ECG? Followup: he was found to have hyperparathyroidism == MY Comment , by K EN G RAUER, MD ( 9/12 /2023 ): == Today's ECG is remarkable for an uncommon but important finding that we periodically review, because it otherwise is all-too-easy to overlook. There is a very short QT interval.

EKG/ECG 69

EKG/ECG Hospitals 69

Dr. Smith's ECG Blog

DECEMBER 5, 2022

I received this ECG in a text message, with the message: "Hey, these look like hyperacute T waves to me, what do you think? Here is her old ECG:" What do you think? Here is my response: "There is something wrong with this ECG. Change the location of the limb Electrodes and repeat the EKG. What do you think? 2010.12.162.

EKG/ECG 52

EKG/ECG 52

Dr. Smith's ECG Blog

JANUARY 30, 2018

This ECG was recorded: This was sent to me in a text that woke me from sleep, but not simultaneous with patient care. Later, I looked into the chart and found an ECG from a few days before: I texted back: "Those T-waves were gone 5 minutes later. Asymptomatic ST-Segment–Elevation ECG in Patient With Kidney Failure. 2010.12.162.

EKG/ECG 52

EKG/ECG 52

Dr. Smith's ECG Blog

OCTOBER 13, 2022

There were no prior ECGs, the first ECG was signed off as unremarkable, and the patient waited to be seen. An hour later the first troponin returned at 49 ng/L (normal <16 in females and <26 in males), so the patient was brought into an acute bed and the ECG was repeated, with ongoing symptoms. What do you think?

EKG/ECG 52

EKG/ECG 52

Dr. Smith's ECG Blog

AUGUST 3, 2017

This is his 12-Lead ECG: What do you think?​ Firstly, subendocardial ischemia does not localize on 12-Lead ECG. The precordial ST-depression pattern on this ECG (and in this clinical setting) should immediately raise suspicion of Posterior STEMI! What's also interesting to note is that there is ST-elevation in V6 on the ECG.

EKG/ECG 52

EKG/ECG Outcomes Wellness 52

Taming the SRU

NOVEMBER 29, 2023

Lumbar puncture with xanthochromia or > 2000 RBCs in tube 4 should increase suspicion for SAH. Workup with a negative troponin and EKG reliably rules out BCI. There is growing evidence that negative NCHCT + CTA outside of traditional 6-hour window is sufficient for diagnosis.

Stroke 53

Stroke EKG/ECG Resuscitation Shock 53

RebelEM

JUNE 26, 2024

patients can jump from peaked T waves to sine wave) Management Basics: ABCs, IV, O 2 , Cardiac Monitor and, 12-lead EKG Identify + treat underlying cause of hyperkalemia (i.e. Definition: A serum potassium level > 5.5 rhabdomyolysis -> hydration) Remove inciting factors (i.e. furosemide) Dialysis for anuric patients (i.e.

EKG/ECG 58

EKG/ECG Administration Burns EMS 58

PEMBlog

MAY 15, 2023

The majority of these are cardiac and so today we will review what to look for in your screening ECG. This is why ECG is recommended for all initial episodes of syncope with a reported sensitivity as high as 96%. Therefore, what are we looking for with our ECG? Concerning ECG findings Long QT syndrome: QTc longer than 480 msec.

Pediatrics 97

Pediatrics EKG/ECG Emergency Department Burns 97

EMDocs

MAY 15, 2024

ECG: Evaluate for ischemia, right heart strain. National Acute Chest Syndrome Study Group [published correction appears in N Engl J Med 2000 Sep 14;343(11):824]. Overestimates arterial oxygen saturation. Up to 3x less accurate in black patients. When the clinical picture does not match the SpO 2 , get an ABG. N Engl J Med.

Blood Transfusions 103

Blood Transfusions Fluid Resuscitation Dehydration Ultrasounds 103

EMDocs

MAY 28, 2024

ECG: Evaluate for ischemia, right heart strain. National Acute Chest Syndrome Study Group [published correction appears in N Engl J Med 2000 Sep 14;343(11):824]. Overestimates arterial oxygen saturation. Up to 3x less accurate in black patients. When the clinical picture does not match the SpO 2 , get an ABG. N Engl J Med.

Blood Transfusions 97

Blood Transfusions Fluid Resuscitation Dehydration Ultrasounds 97

Don't Forget the Bubbles

OCTOBER 7, 2024

Suspected low voltage injuries (<1000v) should still be approached with an A-E assessment, but if 12 lead ECG and urinalysis are normal, it’s reasonable to discharge the patient. If the ECG is abnormal, the patient should be managed as if exposed to a high voltage (>1000v). 2000 Aug;46(1–3). Wiley; 2016.

Burns 80

Burns Fluid Resuscitation Shock Resuscitation 80

Rural Doctors Net

JANUARY 21, 2014

Facilities include small resus bay with point-of-care INR, proBNP and Chem 4/Chem 8 iStat, CXR (but you have to take the radiograph yourself), and the usual resus drugs, 2 lead ECG, telemetry, adrenaline as sole inotrope etc. There’s an old Oxylog 2000 plus transport ventilator. Q3 : Her ECG is as below. HR 123 a/fib.

EKG/ECG 52

EKG/ECG Ultrasounds 52

EMDocs

SEPTEMBER 25, 2023

Chest 2000; 117(1): 260 – 7. 2000 Jan-Mar;4(1):14-8. Notable Physical Exam: General: Tripoding, severe respiratory distress. PMID: 23911630 Kim WY et al. actors Associated with the Occurrence of Cardiac Arrest after Emergency Tracheal Intubation in the Emergency Department. PLoS One 2014; 9(11): e112779. PMID: 10631227 Mosier JM et al.

Emergency Department 92

Emergency Department Soft Tissue Injuries Airway Management Operations 92

Pediatric Emergency Playbook

JUNE 1, 2017

Electrocardiography (ECG) should be performed on any patient with significant blunt chest injury. A negative ECG is highly consistent with no significant blunt myocardial injury. Any patient with a new abnormality on ECG (dysrhythmia, heart block, or signs of ischemia) should be admitted for continuous ECG monitoring.

Pediatrics 52

Pediatrics EKG/ECG Wellness Seizures 52

Dr. Smith's ECG Blog

OCTOBER 11, 2020

Here is his first ED ECG: What do you see? STD maximal in V1-V4 (in this case V3-V4) is in my opinion the single best way to identify posterior OMI on the anterior 12 lead ECG. Another ECG was recorded based on the elevated troponin and ongoing symptoms: The heart rate is slightly lower. Apparently he denied chest pain.

EKG/ECG 52

EKG/ECG Hospitals Outcomes Wellness 52

Dr. Smith's ECG Blog

APRIL 8, 2015

Abnormal ECG – looks for cardiac syncope. Abnormal Electrocardiogram (ECG): Defined (San Fran syncope rule) as any new changes when compared to the last ECG or presence of non-sinus rhythm. If no previous ECG was available, ECG was classified as abnormal if any abnormality was present. orthostatic vitals b.

Emergency Department 52

Emergency Department EKG/ECG Outcomes Seizures 52

EMDocs

NOVEMBER 4, 2024

Pain can be associated with a friction rub on cardiac auscultation, a pericardial effusion on a bedside echocardiogram, or diffuse ST elevations on an EKG. Prevalence and treatment of pain in EDs in the United States, 2000 to 2010. Up to two-thirds of rib fractures are missed on initial chest radiographs. Am J Emerg Med.

Emergency Department 105

Emergency Department Fractures Burns EMS 105

Dr. Smith's ECG Blog

FEBRUARY 17, 2023

. = Comment by K EN G RAUER, MD ( 2/11 /2023 ): = Today’s case is from a patient with “many complaints”, including chest pain — and, an ECG that raised concern about acute anterior OMI. These are: On careful review — the patient’s initial ECG is not suggestive of acute OMI. Figure-1: I’ve labeled the initial tracing in today’s case.

EKG/ECG 52

EKG/ECG Hospitals Wellness 52

Dr. Smith's ECG Blog

FEBRUARY 26, 2025

Below is his presentation ECG. The above ECG was originally recorded with a paper speed of 50mm/sec. Interpretation: The ECG shows sinus rhythm at 94 beats per minute. This ECG shows a lot of "acuity". The ECG findings in isolation must be assumed to be acute MI until proven otherwise. What do you think?

EKG/ECG 88

EKG/ECG Shock COPD Wellness 88

Sensible Medicine

JANUARY 27, 2025

All patients had regular clinical evaluation, including exercise electrocardiography (ECG) if deemed appropriate, before being randomly assigned to either standard care or standard care plus CTA. Nearly 90% of both groups had ECG stress tests at baseline. This was the original primary endpoint ).

Outcomes 121

Outcomes EKG/ECG Documentation/Coding Academics 121

Taming the SRU

JANUARY 22, 2025

Chronic obstructive pulmonary disease surveillance--United States, 1971-2000. Saloni Dattani, Fiona Spooner, Hannah Ritchie and Max Roser (2023) - Causes of Death Published online at OurWorldinData.org. Retrieved from: '[link] [Online Resource] Mannino DM, Homa DM, Akinbami LJ, Ford ES, Redd SC. MMWR Surveill Summ. 2002 Aug 2;51(6):1-16.

COPD 80

COPD CDC Research Emergency Department 80

Taming the SRU

NOVEMBER 13, 2024

haffner and wright The number of psychiatric emergencies across the U.S., mg/kg (of 0.1 2x maintenance rate

Psychiatric 89

Psychiatric Seizures Emergency Department Pediatrics 89