2003 and EKG/ECG - Emergency Care Today

A teenager involved in a motor vehicle collision with abnormal ECG

Dr. Smith's ECG Blog

FEBRUARY 6, 2024

Here is his initial ECG around 1330: What do you think? The ECG shows sinus tachycardia with RBBB and LAFB, without clear additional superimposed signs of ischemia. Initial high sensitivity troponin I: 3,830 ng/L (URL 20 ng/L for men) 1445: Similar to initial ECG. He was intubated for altered mental status.

EKG/ECG

EKG/ECG Wellness Fractures Emergency Department

emDOCs Revamp: Alcohol Withdrawal

EMDocs

DECEMBER 18, 2024

2003; 348:1786-1795. fold higher risk of NSTI than the control group 12 For those without comorbidities , AUD exhibited a 15.2-fold Management of drug and alcohol withdrawal. N Engl JMed. Gortney J, Raub J, Patel P, et al. Alcohol withdrawal syndrome in medical patients. Cleve Clin J Med. 2016; 83(1): 67-79. Muncie H, Yasinian Y, Oge L.

Seizures

Seizures Hyperthermia / Hypothermia Emergency Department EMS

SGEM#430: De Do Do Do, De Dash, Dash DAShED – Diagnosing Acute Aortic Syndrome in the ED.

The Skeptics' Guide to EM

FEBRUARY 11, 2024

The ECG shows sinus tachycardia with non-specific ST-T changes. This study found that between 2003 and 2018, there were 1,299 cases of AAS in Ontario, the largest province in the country. She is bradycardic, hypotensive, and tachypneic. She is received in the resuscitation room. The chest x-ray is unremarkable. per 100,000. [4-8]

Emergency Department

Emergency Department Resuscitation Hospitals EKG/ECG

ACMT Toxicology Visual Pearl: The Heart Won’t Go On and On

ALiEM

JUNE 15, 2023

An ECG may show signs similar to digoxin exposure Classic “scooping” of ST segments Heart blocks Dysrhythmias Hyperkalemia may be seen with severe cardiac glycoside poisoning. Serial ECGs and monitoring of serum potassium should be done in cases of severe poisoning. Lancet 2003; 361 (9373): 1935-8.

Poisoning

Poisoning EKG/ECG Hospitals

Patient in Single Vehicle Crash: What is this ST Elevation, with Peak Troponin of 6500 ng/L?

Dr. Smith's ECG Blog

NOVEMBER 25, 2022

As a routine part of his critical trauma evaluation, he had an ECG recorded: There is an rSR" in V1 and V2, with downsloping ST segment and inverted T-wave which is very similar to a Brugada Type 1 phenocopy. On the other hand, the RV lies directly under leads V1 and V2; this makes pneumothorax less likely as an etiology of the abnormal ECG.

EKG/ECG

EKG/ECG Fractures Hyperthermia / Hypothermia Wellness

Diffuse Subendocardial Ischemia on the ECG. Left main? 3-vessel disease? No!

Dr. Smith's ECG Blog

NOVEMBER 19, 2016

An immediate 12-lead EKG was obtained: There is ST elevation in leads aVR and V1, with marked ST depression in I, II, III, aVF, V3-V6. DISCUSSION: The 12-lead EKG EMS initially obtained for this patient showed severe ischemia, with profound "infero-lateral" ST depression and reciprocal ST elevation in lead aVR. What should be done?

EKG/ECG

EKG/ECG Shock Fluid Resuscitation Documentation/Coding

What is strange about this paroxysmal atrial fibrillation in an otherwise healthy patient? And what happened after giving ibutilide?

Dr. Smith's ECG Blog

MARCH 15, 2023

Here is her EKG: What is unusual about this? Here is the ECG after ibutilide: What do you notice? Here is the post-cardioversion ECG: Sinus rhythm, still with the longer QT interval. For more on SSS — See My Comment at the bottom of the page in the July 5, 2018 post in Dr. Smith’s ECG Blog. She was on no medications.

EKG/ECG

EKG/ECG Dehydration Stroke Shock

A 60 year old with chest pain

Dr. Smith's ECG Blog

JANUARY 17, 2023

Here is his first ECG: What do you think? Whenever you see a bizarre ECG, look at leads I, II, and III. So I asked the tech to record the ECG again, but move the left leg electrode. In the December 5, 2022 post of Dr. Smith's ECG Blog — We show 4 additional cases of this pulse-tap artifact. It looks bizarre, doesn't it?

EKG/ECG

EKG/ECG Wellness

Annals of B Pod - Opioid-Associated Hearing Loss

Taming the SRU

APRIL 10, 2023

UDS : positive for amphetamines, benzodiazepines, fentanyl, THC EKG : Normal sinus rhythm, incomplete right bundle branch block, normal axis, normal intervals. without signs of ischemia on EKG, an elevated CK of 1900, and a mild acute kidney injury with a creatinine of 1.56. 2003 May 27;168(11):1421-3. Diagnostics WBC : 8.6

EKG/ECG

EKG/ECG Fluid Resuscitation Administration Emergency Department

Prehospital Traumatic Cardiac Arrest: A Systematic Review and Meta-analysis

RebelEM

MARCH 13, 2023

The only statistically significant factor intra-arrest was the first ECG rhythm, which only had an odds ratio of 1.12, which is relatively low. Apart from the first monitored ECG rhythm, this study found no other prognostic factors available to differentiate between survivors and non-survivors.” 2003 Feb;237(2):153-60.

Basic Life Support

Basic Life Support EMS Outcomes Resuscitation

MI in Children

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

Pediatrics EKG/ECG Wellness Seizures

Emergency Department Syncope Workup: After H and P, ECG is the Only Test Required for Every Patient.

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

Emergency Department EKG/ECG Outcomes Seizures

ToxCard: Organic Mercury Poisoning

EMDocs

JULY 19, 2023

2003 Oct 30;349(18):1731-7. Mercury, in all forms, reacts with sulfhydryl groups in intracellular sites ultimately interfering with multiple enzymatic processes. Ten Things Physicians and Patients Should Question. link] Clarkson TW, Magos L, Myers GJ. The toxicology of mercury–current exposures and clinical manifestations. N Engl J Med.

Poisoning

Poisoning Fluid Resuscitation Administration Seizures

Syncope and a short pause on event monitor

Dr. Smith's ECG Blog

FEBRUARY 4, 2025

From VPS II Connolly et al JAMA, 2003 ) Answer: No significant reduction in syncope!! PAVB is characterized by the sudden, unexpected onset of complete AV block with delayed ventricular escape therefore resulting in a potentially prolonged period without any QRS on ECG. The baseline ECG before idiopathic PAVB tends to be normal.

EKG/ECG

EKG/ECG Documentation/Coding Operations Wellness

Emergency Care Today

A teenager involved in a motor vehicle collision with abnormal ECG

emDOCs Revamp: Alcohol Withdrawal

Trending Sources

SGEM#430: De Do Do Do, De Dash, Dash DAShED – Diagnosing Acute Aortic Syndrome in the ED.

ACMT Toxicology Visual Pearl: The Heart Won’t Go On and On

Patient in Single Vehicle Crash: What is this ST Elevation, with Peak Troponin of 6500 ng/L?

Diffuse Subendocardial Ischemia on the ECG. Left main? 3-vessel disease? No!

What is strange about this paroxysmal atrial fibrillation in an otherwise healthy patient? And what happened after giving ibutilide?

A 60 year old with chest pain

Annals of B Pod - Opioid-Associated Hearing Loss

Prehospital Traumatic Cardiac Arrest: A Systematic Review and Meta-analysis

MI in Children

Emergency Department Syncope Workup: After H and P, ECG is the Only Test Required for Every Patient.

ToxCard: Organic Mercury Poisoning

Syncope and a short pause on event monitor

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