Dr. Smith's ECG Blog

NOVEMBER 28, 2022

Given her reported chest pain, shortness of breath, and syncope, an ECG was quickly obtained: What do you think? Given her tachycardia and episodes of syncope, the patient was judged to be in compensated obstructive shock with very high risk of imminent decompensation. 2013 Sep;26(9):965-1012.e15. J Am Soc Echocardiogr.

EKG/ECG 40

EKG/ECG Ultrasounds Documentation/Coding COPD 40

EB Medicine

JULY 8, 2019

Jeff: Do note, however that 2013 guidelines do not recommend one procedure over another and leave that decision up to local surgical expertise, patient specific risk factors, and treatment goals. Consider performing a RUSH exam (that is rapid ultrasound for shock and hypotension) to identify the cause.

Emergency Department 40

Emergency Department Sepsis Operations Dehydration 40

RebelEM

SEPTEMBER 28, 2023

The STREAM-1 trial found that for [2] patients with STEMI presenting within 3 hours of symptom onset and unable to attain PCI within 1 hour of first medical contact, a pharmaco-invasive strategy resulted in similar rates of death, shock, heart failure, or reinfarction compared to primary PCI. Primary PCI: 95.7% Primary PCI: 95.7%

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EKG/ECG Allergic Reactions Shock Stroke 138

Dr. Smith's ECG Blog

AUGUST 9, 2019

Some total LAD occlusion manifest on the ECG similarly to some left main occlusions. Depending on where the STE vector of the LM occlusion shows up on the ECG, there may be either STE, or STD, or neither in aVR, and lead aVR will not be the important part of the ECG interpretation in these cases.

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EKG/ECG Shock Emergency Department Wellness 52

Dr. Smith's ECG Blog

MAY 8, 2023

Triage ECG: What do you think? Code STEMI was activated by the ED physician based on the diagnostic ECG for LAD OMI in ventricular paced rhythm. Queen of Hearts interpretation: The cardiologist initially was not convinced, stating the ECG was not diagnostic or could not be diagnostic because it was paced. No labs were performed.

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EKG/ECG Documentation/Coding Outcomes Shock 52

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

MAY 5, 2022

Here is the initial ED ECG: What do you think? The ECG shows peaked T waves, QRS widening, a coved-type ST segment with inverted T waves most prominent in V1 and V2 consistent with Brugada pattern. They recommended repeating his ECG and awaiting troponin since the patient did not have any chest pain. Creatinine elevated at 3.09

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EKG/ECG Fluid Resuscitation EMS Shock 52

Rural Doctors Net

AUGUST 30, 2013

Whilst we’ve ‘re-discovered’ balanced resuscitation (first described by Cannon back after WWI), there remains some limited controversy – listen to this 2013 take from Simon Carley at St. Our patient will need adequate pre-oxygenation with a bag-mask valve- be aware that not all bag-masks are the same! Emlyns on the PROMMT data.

Burns 52

Burns Hospitals Wellness Ambulance Services 52

Dr. Smith's ECG Blog

APRIL 9, 2025

This was her prehospital ECG: What do you think? ECG many months later: RBBB with well-formed Q-waves in V1-V6, also I, aVL. Primary VF in this study refers to fibrillation occurring in the absence of shock or pulmonary edema. For clarity in Figure-1 I've reproduced and labeled this initial ED ECG.

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EKG/ECG Resuscitation Administration Shock 63

Dr. Smith's ECG Blog

DECEMBER 23, 2024

Written by Willy Frick A woman in her 70s is hospitalized with undifferentiated shock after being found down at home. Hint: What does the arterial waveform correspond to on the ECG? The transcutaneous pads are delivering shocks at a rate of 70 per minute. The transcutaneous pads are delivering shocks at a rate of 70 per minute.

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EKG/ECG Shock Ultrasounds Sepsis 114

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?

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EKG/ECG Shock COPD Wellness 88

Dr. Smith's ECG Blog

MARCH 8, 2025

Her first ECG is shown. After this ECG was obtained, the ER physician received word that the patient's husband had died in the crash. Repeat ECG was obtained immediately, just 24 minutes after the prior ECG: Given the context, my top differential diagnosis would be stress cardiomyopathy AKA takotsubo. Overall bland.

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EKG/ECG CPR Resuscitation Wellness 75