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ECG Blog #366 — Diltiazem didn't work.

Ken Grauer, MD

The ECG and long lead II rhythm strip in Figure-1 — was obtained from a COVID positive patient with persistent tachycardia not responding to Diltiazem. Figure-1: The initial ECG — obtained from a patient with persistent tachycardia. ( To improve visualization — I've digitized the original ECG using PMcardio ).

EKG/ECG 195
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An elderly male with acute altered mental status and huge ST Elevation

Dr. Smith's ECG Blog

A man in his 90s with a history of HTN, CKD, COPD, and OSA presented to the emergency department after being found unresponsive at home. 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. or basilar ischemia.

EKG/ECG 94
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VT? Or Supraventricular tachycardic rhythm with aberrancy?

Dr. Smith's ECG Blog

Here is a normal LBBB: In LBBB, monophasic wide R-waves should be limited to the lateral leads in left bundle branch block, as in this ECG. In that ECG above, there are monophasic R-waves starting in lead V2 all the way out to V6. But why does this EKG look nothing like left bundle branch block? Is this sinus tachycardia or VT?

EKG/ECG 134
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Proportionality is a major element in the ECG Diagnosis of OMI.

Dr. Smith's ECG Blog

This is the result for this ECG, from MDcalc.com : The most accurate cutpoint is 18.2. Here is a similar case from Pendell: This ECG was handed over at triage. That said — the ST-T wave in lead V2 looks to be small only if viewed in the context of its absolute height, as one of 12 leads in the initial ECG shown above in today's post.

EKG/ECG 109
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Is all this "ST Depression" due to ischemia?

Dr. Smith's ECG Blog

Written by Magnus Nossen, with some edits by Smith This ECG was transmitted electronically by EMS for evaluation. How would you interpret the ST changes seen in this ECG? Will you accept this patient for emergent coronary angiogram based on the ECG changes? Does the ECG represent STEMI-negative OMI findings?

EKG/ECG 69
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emDOCs Podcast – Episode 98: Post ROSC Mental Model

EMDocs

Check the pulse RSI= Resuscitation Sequence Intubation Hypoxia, Hypotension, and Acidosis are the reason patients code during/post intubation These patients are super high risk for all 4 Optimize first pass success – Induction agent + paralytic Unconscious patients will still have muscle tone Induction Ketamine or Etomidate at half doses (i.e.,

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Massive Hemoptysis

EM SIM Cases

Case Summary This is a case of a 57-year-old male with former smoking history, COPD on home O2, atrial fibrillation on anticoagulation coming into a community emergency department (ED) with symptoms consistent with COPD exacerbation. His initial presentation will respond to traditional therapies for COPD exacerbation.

COPD 52