Dr. Smith's ECG Blog

JUNE 26, 2023

Figure-1: The initial ECG in today's case. ( To improve visualization — I've digitized the original ECG using PMcardio ). As I discuss in detail in My Comment at the bottom of the page in the May 24, 2020 post in Dr. Smith's ECG Blog — AV dissociation is not the same as AV block. How would YOU interpret this tracing?

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EKG/ECG Seizures Sepsis Operations 97

Dr. Smith's ECG Blog

JANUARY 15, 2024

Colin is an emergency medicine resident beginning his critical care fellowship in the summer with a strong interest in the role of ECG in critical care and OMI. An ECG was obtained shortly after arrival: ECG 1 What do you think? The ECG has a lot of artifact, and the amplitude is very small, making interpretation challenging.

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EKG/ECG Wellness Point-of-Care Testing Shock 64

Mind The Bleep

OCTOBER 29, 2024

Circulation Assess heart rate, blood pressure, peripheral and central CRT, pulses and 3 lead ECG. These systemic effects can include central nervous system (agitation, seizures , and coma), as well as cardiac ( hypotension and dysrhythmias) [10, 11]. Administer high-flow oxygen if indicated and consider arterial blood gas ( ABG ).

Burns 52

Burns Fluid Resuscitation PPE Resuscitation 52

EMDocs

JANUARY 17, 2024

Her electrocardiogram (ECG) showed atrial fibrillation which was cardioverted to sinus rhythm. A 2020 National Poison Data System (NPDS) study comparing pre-DSC and post-DSC benzonatate poisonings showed no decrease in the severity nor incidence of benzonatate poisonings reported to US poison control centers. (1)

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Poisoning Seizures Pediatrics EMS 89

Dr. Smith's ECG Blog

JUNE 17, 2016

He had a seizure this morning and rolled out of bed unable to get up. The medics recorded a prehospital ECG: The computerized QTc is 397 ms Jason writes: " What's your thoughts Steve?" Unfortunately, the R-wave is cut off on this ECG but it appears as if it would be at least 20 mm. So this was the patient's baseline ECG.

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EKG/ECG Seizures EMS Outcomes 52

Dr. Smith's ECG Blog

AUGUST 13, 2020

Then I looked into the patient's chart and found an old EKG: This shows a previous QR-wave in V2, diagnostic of old anterior MI. I wrote back: "I am looking at his old EKG. The cath lab had been activated and then they sent me the ECG. They agreed that the ECG findings were due only to old MI and tachycardia.

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EKG/ECG Shock Stroke Seizures 52

Dr. Smith's ECG Blog

FEBRUARY 4, 2023

He had a seizure this morning and rolled out of bed unable to get up. The medics recorded a prehospital ECG: The computerized QTc is 397 ms Jason writes: " What's your thoughts Steve?" Unfortunately, the R-wave is cut off on this ECG but it appears as if it would be at least 20 mm. So this was the patient's baseline ECG.

EKG/ECG 52

EKG/ECG Seizures EMS Outcomes 52

EMDocs

MAY 15, 2024

ECG: Evaluate for ischemia, right heart strain. American Society of Hematology 2020 guidelines for sickle cell disease: transfusion support. Published 2020 Feb 12. Infectious: bacterial or viral pneumonia ( M. pneumoniae, C. Overestimates arterial oxygen saturation. Up to 3x less accurate in black patients. 2020;4(2):327-355.

Blood Transfusions 103

Blood Transfusions Fluid Resuscitation Dehydration Ultrasounds 103

EMDocs

MAY 28, 2024

ECG: Evaluate for ischemia, right heart strain. American Society of Hematology 2020 guidelines for sickle cell disease: transfusion support. Published 2020 Feb 12. Infectious: bacterial or viral pneumonia ( M. pneumoniae, C. Based on light absorption from blood flow at the sensor site (using HbA, not HbS). 2020;4(2):327-355.

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Blood Transfusions Fluid Resuscitation Dehydration Ultrasounds 97

Cook County EM Blog

MAY 29, 2023

Signs and symptoms of toxicity include alerted mental status, seizures, CNS depression, apnea, respiratory failure, hypotension, ventricular dysrhythmias, and cardiac arrest. If a therapeutic dose is chewed, it can lead to bronchospasm, laryngospasm, seizures, and cardiovascular collapse which further reinforces the danger to children.

Seizures 52

Seizures Administration Resuscitation Poisoning 52

EMDocs

NOVEMBER 1, 2023

1 , 2 The most common non-iatrogenic cause is spontaneously due to increased intraesophageal pressure, Boerhaave syndrome, from forceful retching, coughing, straining, seizures, or even childbirth (15% of cases). McGraw-Hill Education; 2020. upper endoscopy, transesophageal echo, etc.). aid=1104586430 Bono MJ. Esophageal Emergencies.

Operations 93

Operations Radiology Radiology Fluid Resuscitation 93

EMDocs

SEPTEMBER 25, 2023

Contraindicated seizures or porphyria. Epub 2020 Dec 9. 2020 Jul;158(1):45-47. Epub 2020 Jul 2. ” Journal of the Medical Association of Thailand 103 (2020). Notable Physical Exam: General: Tripoding, severe respiratory distress. Minimal histamine release. Cons: Short duration of action. Pain upon injection.

Emergency Department 92

Emergency Department Soft Tissue Injuries Airway Management Operations 92

EMDocs

DECEMBER 16, 2023

A 12-lead EKG shows sinus tachycardia but is otherwise normal. As you attempt to examine the patient, he has a generalized, tonic-clonic seizure. Clinical decision making in seizures and status epilepticus. Triage vital signs include BP 80/40 mm Hg, HR 154 bpm, T 41C rectal, RR 28 breaths per minute, saturation 94% on room air.

Hyperthermia / Hypothermia 94

Hyperthermia / Hypothermia EMS Stroke Seizures 94

Dr. Smith's ECG Blog

JANUARY 21, 2023

The patient had a witnessed generalized tonic-clonic seizure leading to GCS 4. In the resuscitation room, the patient had another seizure that stopped after IV Lorazepam. ECG met STEMI criteria and was labeled STEMI by computer interpretation. ECG met STEMI criteria and was labeled STEMI by computer interpretation.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia EKG/ECG Seizures Fractures 52

Taming the SRU

NOVEMBER 13, 2024

haffner and wright The number of psychiatric emergencies across the U.S., haffner and wright The number of psychiatric emergencies across the U.S., haffner and wright The number of psychiatric emergencies across the U.S., mg/kg (of 0.1 mg/kg (of 0.1 2x maintenance rate

Psychiatric 89

Psychiatric Seizures Emergency Department Pediatrics 89

EMDocs

NOVEMBER 4, 2024

Pain can be associated with a friction rub on cardiac auscultation, a pericardial effusion on a bedside echocardiogram, or diffuse ST elevations on an EKG. Epub 2020 Oct 31. Epub 2020 Oct 31. 2020 Apr/Jun;42(2):96-102. 2020 Jul;95(7):E160-E163. Epub 2020 May 1. Migraines: Migraines cause approximately 1.2

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Emergency Department Fractures Burns EMS 105

EMDocs

JULY 19, 2023

Further, organic mercury readily crosses the placenta where it acts as a teratogen leading to a wide range of birth defects including developmental delay, blindness, seizures, and limb malformation. 2020 Aug 15;417:213343. Epub 2020 May 7. Sulfhydryl groups as targets of mercury toxicity. Coord Chem Rev. doi: 10.1016/j.ccr.2020.213343.

Poisoning 92

Poisoning Fluid Resuscitation Administration Seizures 92

Taming the SRU

FEBRUARY 3, 2025

These can lead to a wide spectrum of emergent complications including but not limited to cardiac dysrhythmias, seizures, and acute renal failure. This can often become significant enough to precipitate dysrhythmias, seizures, and tetany (20). McGraw-Hill Education; 2020:962-963. in females and 2.5-7.0 Accessed January 21, 2025.

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Fluid Resuscitation Seizures Dehydration Emergency Department 56