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ECG Blog #448 — A Young Man with Chest Pain.

Ken Grauer, MD

The ECG in Figure-1 was obtained from a previously healthy man in his early 20s — who initially presented with GI symptoms, that then evolved into CP ( C hest P ain ). QUESTIONS: Given the above history — How would YOU interpret the initial ECG that is shown in Figure-1 ? Figure-1: The initial ECG in today's case. (

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Patient with severe DKA, look at the ECG

Dr. Smith's ECG Blog

Here is the ECG: Sinus tachycardia. This is an extremely dangerous ECG. When the ECG shows the effects of hypokalemia, it is particularly dangerous. Here are the American Heart Association Guidelines: 2005 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Part 10.1:

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Severe shock, obtunded, and a diagnostic prehospital ECG. Also: How did this happen?

Dr. Smith's ECG Blog

A prehospital ECG was recorded: Limb leads: Precordial Leads What is the therapy? What does a heart look like on ultrasound when the EKG looks like that? The followup ECG is here: Now the QRS is only slightly prolonged. A middle-aged woman was found down in her apartment unconscious. She was in shock with thready pulses.

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

RebelEM

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. However, we might expect on-scene advanced trauma resuscitation to prolong prehospital time sizably. Cardiopulmonary resuscitation traumatic cardiac arrest—there are survivors.

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STEMI with Life-Threatening Hypokalemia and Incessant Torsades de Pointes

Dr. Smith's ECG Blog

Here is his ED ECG: There is obvious infero-posterior STEMI. After resuscitation, he was found to have a 90% thrombotic lesion in the same saphenous vein graft to the right posterior descending artery. This subsequent ECG was recorded after the K was up to 2.2 These two rhythms are often indistinguishable on the monitor or ECG.

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MI in Children

Pediatric Emergency Playbook

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.

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EM@3AM: Hyperthermia

EMDocs

A 12-lead EKG shows sinus tachycardia but is otherwise normal. Evaporative cooling is the preferred method to actively reduce body temperature in the emergency department , as it can be performed with ongoing resuscitation efforts. Resuscitation. , 148 , 173–190. Temps greater than 41.5C Temps greater than 41.5C Epstein, J.,