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ECG Blog #432 — "Should I Shock this Patient?"

Ken Grauer, MD

No shock was needed. But considering that patients have been shocked for tracings resembling the ECG shown in Figure-1 — it may be worthwhile to present another example. The September 27, 2019 post — for the Rowlands & Moore article with the above-noted formulas for recognizing the “culprit” extremity. Is there a pulse?

Shock 414
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Imported Malaria

Pediatric EM Morsels

ovale to cover the hypnozoite that can stay dormant in the liver and cause a secondary infection in the future Severe Malaria IV artesunate is currently the accepted first line treatment Previously IV quinine was first line, however it was associated with higher incidence of hypoglycemia, cardiac dysrhythmias, seizures, and comas.

Seizures 281
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ToxCard: Second Generation Antipsychotic Overdose

EMDocs

1 Seizures may occur due to lowered seizure threshold. 6 Seizures have been observed and are dose-dependent. 1 Benzodiazepines are preferred as the first line of treatment for agitation or seizures. New York, NY: McGraw-Hill Education; 2019. Cambridge: Cambridge University Press; 2019. Published 2019.

Poisoning 111
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ToxCard: Iron

EMDocs

Stage 3 (timing variable) Shock 1 : Can occur within hours for massive ingestion, but may occur over a longer time course. Characterized by hypovolemia, vasodilation, reduced cardiac output, hyperventilation, elevated temperature, seizure, coma, and cardiovascular collapse. McGraw Hill; 2019. Antiemetics as needed. Tenenbein M.

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Chemical Burns

Mind The Bleep

Sodium Chloride or Hartmanns if indicated, monitoring for signs of shock. These systemic effects can include central nervous system (agitation, seizures , and coma), as well as cardiac ( hypotension and dysrhythmias) [10, 11]. 2019 Nov;34(4):276-281. Epub 2019 Nov 29. Check temperature and blood glucose levels.

Burns 52
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A 40-Something male with a "Seizure," Hypotension, and Bradycardia

Dr. Smith's ECG Blog

This is by one of our outstanding 3rd year residents , Aaron Robinson, with some edits and comments by Smith EMS responded to a reported seizure in a 42 year old male. He reports no personal or familial history of seizures. When the physicians approached him, he was ashen, diaphoretic, and appeared in shock.

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Noisy, low amplitude ECG in a patient with chest pain

Dr. Smith's ECG Blog

Tachycardia is unusual for OMI, unless the patient is in cardiogenic shock (or getting close). Jenkins and Frick — or additional procedures may be ordered and/or patients shocked for artifact simulating VT/VFib ). The September 22, 2019 post — intermittent ST-T wave artifact. The August 26, 2019 post — baseline artifact.

EKG/ECG 64