Remove 2005 Remove EKG/ECG Remove Shock
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46 year old with chest pain develops a wide complex rhythm -- see many examples

Dr. Smith's ECG Blog

These diagnoses were not found in his medical records nor even a baseline ECG. An ECG was obtained shortly after arrival: What do you think? There is no evidence of WPW on this ECG, but it is diagnostic for OMI. If the LAD is completely occluded, then why does the ECG show reperfusion? What are we seeing here?

EKG/ECG 107
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Severe shock, obtunded, and a diagnostic prehospital ECG. Also: How did this happen?

Dr. Smith's ECG Blog

She was in shock with thready pulses. A prehospital ECG was recorded: Limb leads: Precordial Leads What is the therapy? The rate is not fast enough to be causing shock, so if it is VT, the priority is still to treat hyperK and secondarily to cardiovert. They thought it was VT, but did not shock. The K returned at 7.4

Shock 40
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STEMI with Life-Threatening Hypokalemia and Incessant Torsades de Pointes

Dr. Smith's ECG Blog

He appeared to be in shock. Here is his ED ECG: There is obvious infero-posterior STEMI. This subsequent ECG was recorded after the K was up to 2.2 The QT is much shorter There are now clear U-waves in V2 and V3 2 days later, this ECG was recorded with a K of 3.5: He was managed medically with Clopidogrel.

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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. Heat stroke can lead to end-organ dysfunction such as rhabdomyolysis, disseminated intravascular coagulation, cardiogenic shock, liver failure, and cerebral edema. 2005 Oct 5;9(5):R498-501. Temps greater than 41.5C doi: 10.1186/cc3771. Asplund, O’Connor, F.