Dr. Smith's ECG Blog

MARCH 9, 2013

He arrived in the ED and had this ECG recorded:  There are Wellens' waves, type A (upsloping ST segment then inversion of the terminal part of the T-wave - terminal T-wave inversion, or biphasic T-waves) in V2-V4, and aVL. When the patient had chest pain, prior to nitroglycerine, what do you think the ECG showed ? A stent was placed.

EKG/ECG 52

EKG/ECG EMS Outcomes 52

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

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

EMDocs

MAY 15, 2024

ECG: Evaluate for ischemia, right heart strain. Causes and outcomes of the acute chest syndrome in sickle cell disease. 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.

Blood Transfusions 103

Blood Transfusions Fluid Resuscitation Dehydration Ultrasounds 103

EMDocs

MAY 28, 2024

ECG: Evaluate for ischemia, right heart strain. Causes and outcomes of the acute chest syndrome in sickle cell disease. 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.

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

EMDocs

SEPTEMBER 25, 2023

Still, there are those that believe that FPS is more of a physician-centered endpoint that does not fully reflect important patient-centric outcomes (16). 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. Prehosp Emerg Care.

Emergency Department 91

Emergency Department Soft Tissue Injuries Operations Airway Management 91