Remove 2019 Remove EKG/ECG Remove Hyperthermia / Hypothermia
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Hypothermia and drowning

Don't Forget the Bubbles

You request a 12 lead ECG and repeat a blood gas, asking for it to be run on the PICU analyser. Your trusted nurse hands you the ECG: Paediatric ECG interpretation has never been your strong suit. What is the likely cause of Elsa’s ECG changes? You look at her monitor, and an arterial blood gas performed moments ago.

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What is this ECG finding? Do you understand it before you hear the clinical context?

Dr. Smith's ECG Blog

Written by Pendell Meyers First try to interpret this ECG with no clinical context: The ECG shows an irregularly irregular rhythm, therefore almost certainly atrial fibrillation. These are Osborn waves usually associated with hypothermia. C), with Cardiac Echo -- A Pathognomonic ECG. Is there a long QT?

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ToxCard: Second Generation Antipsychotic Overdose

EMDocs

1,2 Neuroleptic malignant syndrome (NMS) (hyperthermia, autonomic instability, rigidity, altered mental status [AMS]) can occur as well and is most often seen with clozapine but has been observed with other atypicals. Rigidity and hyperthermia should raise concerns for NMS. 1 Seizures may occur due to lowered seizure threshold.

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Hyperthermia and ST Elevation

Dr. Smith's ECG Blog

An initial EKG was obtained: Computer read: sinus tachycardia, early acute anterior infarct. Here is her prior EKG: When compared to the old EKG – Q waves present before, TWI in aVR present before, but all other changes are new. What is the differential for this EKG? T wave inversion III, aVR, TWF in aVF. Is this an OMI?

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An elderly male with acute altered mental status and huge ST Elevation

Dr. Smith's ECG Blog

EKG on arrival to the ED is shown below: What do you think? ng/mL (consistent with prior baseline), and a repeat EKG was obtained 1 hour after the initial EKG. limb lead reversal is now resolved) Unfortunately, QOH V1 got tricked by this second ECG! 2) There was no terminal QRS distortion on these ECGs.

EKG/ECG 103
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Hypothermia at 18 Celsius in V Fib arrest: CPR, then ECMO rewarming, for 3 hours, then Defib with ROSC. Interpret the ECG.

Dr. Smith's ECG Blog

A 12-lead ECG was recorded: There is sinus rhythm with RBBB and right axis deviation. Guide to this image: 30 minutes later, at 31 C, this ECG was recorded: The RBBB has resolved. Osborn waves persist The next day, this ECG was recorded at a normal temperature: Peak hs troponin I was 650 ng/L Day 1 echo ECMO flow 2.9

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The EMERGE Trial: Emergency vs Delayed Catheterization in Survivors of Out-of-Hospital Cardiac Arrest

RebelEM

The TOMAHAWK (Desch 2021), COACT (Abella 2019), and PEARL (Lemkes 2019) trials examined patients with OHCA without ST elevation with a shockable rhythm, and investigators found no difference in delayed versus emergency angiogram. Article: How-Berlemont C, Lamhaut L, Diehl J, et al. Additionally, the trial had several biases.