Dr. Smith's ECG Blog

AUGUST 2, 2024

His ECG is shown below. How does RCA occlusion fit with the ECG? The answer is that the ECG really shows right ventricular OMI. the investigators reviewed outcomes in 118 patients presenting with NSTEMI. Written by Willy Frick A 50 year old man with no medical history presented with acute onset substernal chest pain.

EKG/ECG 121

EKG/ECG Fluid Resuscitation Academics Resuscitation 121

Dr. Smith's ECG Blog

OCTOBER 18, 2023

A few days into her hospital stay she developed chest discomfort and the following ECG was recorded. Are these ECG changes related to the CNS infection perhaps? When I saw the ECG of this patient I saw that there was definitely something "off". I sent the top ECG to Dr Smith with no information and without the baseline ECG.

EKG/ECG 124

EKG/ECG Hospitals Academics Outcomes 124

Dr. Smith's ECG Blog

OCTOBER 6, 2023

This is one case where it made a difference: Right Ventricular MI seen on ECG helps Angiographer to find Culprit Lesion Nevertheless, it is sometimes a fun academic exercise to try to predict the infarct artery: An elderly patient had onset of chest pain one hour prior. Here is the prehospital ECG. He called 911.

EKG/ECG 67

EKG/ECG Academics Shock Outcomes 67

The Skeptics' Guide to EM

SEPTEMBER 11, 2021

He heads curriculum and conference for the academic year and is passionate about resident […] The post SGEM#344: We Will…We Will Cath You – But should We After An OHCA Without ST Elevations? The EKG shows sinus tachycardia with nonspecific changes and no ST segment elevations, Q waves, or hyperacute T waves.

EKG/ECG 52

EKG/ECG Academics EMS CPR 52

Dr. Smith's ECG Blog

NOVEMBER 3, 2023

The baseline ECG is basically normal with no ischemia. Here is what the Queen of Hearts says about the Baseline ECG: Active chest pain triage ECG also read as not OMI: She says "not OMI", but she does not have access to the baseline ECG. In the future, we will be able to have her compare with previous and serial ECGs.

EKG/ECG 84

EKG/ECG Shock Documentation/Coding Academics 84

Dr. Smith's ECG Blog

SEPTEMBER 10, 2023

Triage ECG (no prior for comparison): Computer algorithm read: "Sinus rhythm, low voltage QRS, inferior myocardial infarction, probably old." I texted this ECG with no information to Dr. Smith, who immediately said: "If CP, then anterior OMI until proven otherwise." Every note says "no ischemic changes on ECG."

EKG/ECG 79

EKG/ECG Outcomes Academics Documentation/Coding 79

Sensible Medicine

AUGUST 21, 2023

On yesterday’s podcast , I talked with Bobby Yeh, an academic cardiologist who made a compelling case for enhancing credibility of observational research. Another problem, which is possibly surmountable, is the conflation of what one can call “patient outcomes” versus “doctor outcomes.”

Administration 97

Administration Outcomes Research COPD 97

The Skeptics' Guide to EM

SEPTEMBER 19, 2020

Robert’s academic interests include research and evidence-based medicine. Audrey’s academic interests include trauma and resuscitation. Robert’s academic interests include research and evidence-based medicine. Audrey’s academic interests include trauma and resuscitation. Reference: Roberts et al.

Academics 52

Academics Resuscitation EMS Stroke 52

Cook County EM Blog

APRIL 27, 2022

2019.09.007 What : Retrospective cohort study of all droperidol administrations between January 2012 and April 2018 at an academic and pediatric emergency department in the US with 77,000 annual visits. of patients had an ECG in the prior 6 months, 4% had a QTc >500 msec 26.4% Am J Emerg Med. 2020;38(7):1310-1314.

Administration 52

Administration EKG/ECG Emergency Department EMS 52

The Skeptics' Guide to EM

APRIL 21, 2018

He is also the CME editor for Academic Emergency Medicine (AEM). He is also the CME editor for Academic Emergency Medicine (AEM). The EKG and laboratory tests are normal. Clinical Examination for Acute Aortic Dissection: A Systematic Review and Meta-analysis. Corey Heitz is an emergency physician in Roanoke, Virginia.

Emergency Department 52

Emergency Department Academics EKG/ECG Research 52

Dr. Smith's ECG Blog

JANUARY 6, 2023

F Triage ECG: ECG Interpretation: Sinus rhythm with normal QRS. I do not think this ECG is by itself diagnostic of OMI (full thickness, subepicardial ischemia ), b ut comparison to a previous might reveal this ECG as diagnostic of OMI. Cardiology interpretation of the initial ECG: “ST depressions laterally.”

EKG/ECG 52

EKG/ECG Wellness Academics Ultrasounds 52

Dr. Smith's ECG Blog

NOVEMBER 26, 2018

Here is his initial ECG: What do you think? When the team saw this ECG, we obviously noticed the large STE in the inferior leads, with STD in V1-V5, I, and aVL, and STE in V6. Back to the interpretation of the ECG: Does the rhythm matter to you in this case? Again, not an expected outcome with diltiazem). If so, why?

EKG/ECG 52

EKG/ECG Wellness Administration Academics 52

PHEM Cast

APRIL 10, 2016

This was the same principle as in the Rivers trial: the standard care group is the ‘control’ group against which changes in outcome for the ‘intervention’ group are compared. Think about ECG as an example, So, where the box is green, the test has given us the correct result for the patient. Academic Emergency Medicine.

Sepsis 52

Sepsis Fluid Resuscitation Resuscitation Emergency Department 52

EMDocs

SEPTEMBER 25, 2023

Still, there are those that believe that FPS is more of a physician-centered endpoint that does not fully reflect important patient-centric outcomes (16). ” Academic Emergency Medicine 20.1 Notable Physical Exam: General: Tripoding, severe respiratory distress. Continuing Educ Anaesth Crit Care Pain. 2013;14(3):130–5.

Emergency Department 84

Emergency Department Soft Tissue Injuries Airway Management Operations 84

EB Medicine

JULY 8, 2019

Jeff: And while it’s not exactly core EM, we’re going to briefly discuss indications for bariatric surgery, as this is something we don’t often review even in academic training programs. Nachi: Check an EKG immediately after arrival for any patient that may be concerning for ACS. Jeff: Still, the complication rate is low - about 2.3%

Emergency Department 40

Emergency Department Sepsis Operations Dehydration 40

ACEP Now

MAY 10, 2024

His vital signs are normal and the ECG does not demonstrate a myocardial infarction. Primary Outcome: Diagnostic accuracy of identifying Stanford type A and Stanford type B AoDs Secondary Outcomes: Test characteristics of each of the three individual sonographic findings for diagnosing Stanford type A and Stanford type B AoDs.

Ultrasounds 52

Ultrasounds Outcomes Academics Documentation/Coding 52

Dr. Smith's ECG Blog

APRIL 8, 2015

Cardiac Syncope ("True Syncope") Independent Predictors of Adverse Outcomes condensed from multiple studies 1. Abnormal ECG – looks for cardiac syncope. Abnormal Electrocardiogram (ECG): Defined (San Fran syncope rule) as any new changes when compared to the last ECG or presence of non-sinus rhythm.

Emergency Department 52

Emergency Department EKG/ECG Outcomes Seizures 52

Sensible Medicine

JANUARY 27, 2025

Doctors seek therapies that reduce the chance of bad outcomes. When treating patients with suspected coronary disease, typical bad outcomes to prevent are myocardial infarction (MI) and death due to heart disease. Nearly 90% of both groups had ECG stress tests at baseline. This is more than an academic exercise.

Outcomes 120

Outcomes EKG/ECG Documentation/Coding Academics 120

Dr. Smith's ECG Blog

MARCH 14, 2025

At the time of this initial ED ECG, his symptoms were improving ECG #1 on admission to the ED The patient was not seen quickly in the ED as it was a busy shift and the ECG did not meet STEMI criteria. The below ECG was recorded. Does this repeat ECG shed any light on what is going on? ECG #2 repeat in the ED.

EKG/ECG 96

EKG/ECG EMS Outcomes Academics 96

Taming the SRU

JUNE 6, 2023

then need further evaluation Usually with CTA imaging If normal physical exam & ABI>0.9, then need further evaluation Usually with CTA imaging If normal physical exam & ABI>0.9,

Documentation/Coding 64

Documentation/Coding Seizures Psychiatric Wellness 64

Taming the SRU

FEBRUARY 3, 2025

Initial work up when suspicious of this process should include ECG, chest x-ray, urinalysis, and the following labs: CBC, CMP, magnesium, phosphate, calcium, uric acid, VBG (for pH), and lactate dehydrogenase (10). Therefore, it should only be administered in life-threatening arrhythmia and not simply for peaked t waves on ECG (2,20).

Fluid Resuscitation 56

Fluid Resuscitation Seizures Dehydration Emergency Department 56

EMDocs

FEBRUARY 3, 2025

In patients with chest pain, shortness of breath, or volume overload, additional diagnostic considerations include obtaining anelectrocardiogram (ECG), proBNP, and troponin. Avascular necrosis in systemic lupus erythematosus patients: Analysis of the demographics, clinical manifestations, management and outcomes. Egypt Rheumatol.

Stroke 64

Stroke EMS Seizures Outcomes 64