Dr. Smith's ECG Blog

NOVEMBER 12, 2020

He had the following EKG recorded: Low voltage, suggests effusion. He underwent CPR, and regained a pulse after epinephrine, with an organized narrow complex rhythm at 140, but still with severe shock. Assessment was severe sudden cardiogenic shock. He remained hypotensive and in shock. He was moderately hypoxic.

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Shock EKG/ECG Outcomes Hospitals 52

Dr. Smith's ECG Blog

MAY 19, 2020

ECMO Flow was achieved after approximately 1 hour of high quality CPR. In this case, profound shock for 1 hour would result in the same degree of infarction. A followup ECG was recorded 2 days later: No definite evidence of infarction. The Type 2 MI would then have been a result of the prolonged severe shock while in arrest.

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CPR EKG/ECG Shock Ultrasounds 52

AED Leader

JULY 10, 2024

The Powerheart G5 is a user-friendly AED that provides real-time CPR feedback and can be used for adult and pediatric patients. It offers advanced features such as ECG monitoring and multiple rescue capabilities. It offers advanced features such as ECG monitoring and multiple rescue capabilities.

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CPR EKG/ECG Shock Pediatrics 52

Dr. Smith's ECG Blog

OCTOBER 10, 2022

CPR was initiated immediately. Initial ROSC was obtained, during which this ECG was obtained: What do you think? I sent it to 2 of my ECG nerd colleagues with no clinical information whatsoever, who instantly said: "Looks like afib with subendocardial ischemia and right heart strain pattern." "I

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EKG/ECG Resuscitation Ultrasounds CPR 52

Dr. Smith's ECG Blog

NOVEMBER 30, 2019

She was in shock with thready pulses. A prehospital ECG was recorded: Limb leads: Precordial Leads What is the therapy? The rate is not fast enough to be causing shock, so if it is VT, the priority is still to treat hyperK and secondarily to cardiovert. They thought it was VT, but did not shock. The K returned at 7.4

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Shock EKG/ECG Resuscitation Ultrasounds 40

Don't Forget the Bubbles

OCTOBER 7, 2024

Was the patient thrown from the source (suggestive of DC shock and may result in further blunt force trauma)? Children, especially toddlers, may insert objects into outlets, leading to shocks or burns. Electrical devices used near water sources can cause severe shocks. Was the voltage high or low (as below)?

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Burns Fluid Resuscitation Shock Resuscitation 80

The Skeptics' Guide to EM

SEPTEMBER 11, 2021

The paramedics achieve return of spontaneous circulation (ROSC) after CPR, advanced cardiac life support (ALCS), and Intubation. She arrives in the emergency department (ED) with decreased level of consciousness and shock. She has a history of hypertension and non-insulin dependent diabetes mellitus.

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EKG/ECG Academics EMS CPR 52

EMDocs

JANUARY 8, 2024

Emergent coronary angiography is not recommended over a delayed or selective strategy in patients with ROSC after cardiac arrest in the absence of ST-segment elevation, shock, electrical instability, signs of significant myocardial damage, and ongoing ischemia (Level 3: no benefit). o C recommended (Level 1: strong). COR 2b, LOE B-R.

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Seizures Shock CPR Hyperthermia / Hypothermia 82

AED Leader

JULY 19, 2023

Users are given audible instructions in English or Spanish that take them through the steps of CPR and shock delivery. This technology allows chest compressions to continue during an ECG, reducing pauses in CPR which may, in turn, improve survival rates. cprINSIGHT Analysis. cprINSIGHT Analysis. LIFELINKcentral.

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CPR Shock EKG/ECG Hospitals 52

Dr. Smith's ECG Blog

AUGUST 9, 2019

Some total LAD occlusion manifest on the ECG similarly to some left main occlusions. Depending on where the STE vector of the LM occlusion shows up on the ECG, there may be either STE, or STD, or neither in aVR, and lead aVR will not be the important part of the ECG interpretation in these cases.

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EKG/ECG Shock Emergency Department Wellness 52

Dr. Smith's ECG Blog

MARCH 9, 2017

This was her ECG (it is unclear if this was with or without pain): Computerized ECG Read: “Normal sinus rhythm. Normal ECG.” Overall this is a very quiet ECG. link] A repeat ECG was performed 1.5 hrs after the initial ECG) she develops severe, crushing chest pain. Don’t trust the computerized ECG reading.

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EKG/ECG CPR Shock Hospitals 52

ACEP Now

JANUARY 4, 2025

A closer look, though, also shows the technology of the daya bulky, two-way radio for communicating with EMS, metal gurneys, glass saline bottles, and portable ECG monitors the size of a small shopping cart. Notice the use of the medical anti-shock trousers and the ECG machine. Click to enlarge.) Click to enlarge.)

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Forensics Urgent Care Hospitals Emergency Department 52

Dr. Smith's ECG Blog

NOVEMBER 23, 2022

Here is his triage ECG: PM Cardio version: With no other information at all, I sent this ECG to Dr. Smith, who replied: "I think it is real. In other words, this ECG shows sinus rhythm, normal QRS complex, and: --Inferior OMI: STE in III, hyperacute T waves in lead III, reciprocal STD and TWI in aVL. STD in V4-5 too."

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EKG/ECG Shock CPR Outcomes 52

Dr. Smith's ECG Blog

JUNE 11, 2021

Jesse McLaren (@ECGcases), of Emergency Medicine Cases Reviewed by Pendell Meyers and Steve Smith An 85yo with a history of hypertension developed chest pain and collapsed, and had bystander CPR. The paramedics found the patient with ROSC and a GCS 7, and an ECG showing LBBB with possible lateral ST elevation. So the RCA was stented.

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EKG/ECG Documentation/Coding CPR Shock 52

AED Leader

DECEMBER 2, 2024

Furthermore, regular maintenance and training in cardiopulmonary resuscitation (CPR) techniques significantly enhance the potential effectiveness of AEDs in emergencies. Defibrillation: Once a dangerous rhythm is detected, the AED delivers a controlled electric shock to help restore normal heart rhythm.

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CPR Basic Life Support Resuscitation Hospitals 52

Dr. Smith's ECG Blog

MARCH 11, 2016

Her prehospital ECG was identical to her first ED ECG, and the cath lab was activated: There is massive ST elevation (greater than 15 mm) in V2 and V3, with ST elevation in I and aVL and reciprocal ST depression in II, III, aVF. This comes from chapter 28 of my book The ECG in Acute MI ). hours when she called 911. ng/mL time 1.5

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EKG/ECG Outcomes CPR Shock 52

EB Medicine

NOVEMBER 1, 2018

Thankfully, that gentleman was successfully resuscitated despite no bystander CPR, and if you listen carefully, we hope to arm you with the tools to do so similarly. Nachi: Each year, in the US, approximately 10,000 patients present with electrical burns or shocks. Thankfully, fatalities are declining, with just 565 in 2015.

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Emergency Department Burns EKG/ECG Shock 40

EB Medicine

MARCH 1, 2019

Consider valvular injury in any patient who appears to be in cardiogenic shock, has hypotension without obvious hemorrhage, or has pulmonary edema. In those with severe injury, you may note refractory hypotension secondary to cardiogenic shock. New EKG findings requires admission for monitoring. of those patients.

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Emergency Department EKG/ECG Operations Fractures 40

The Skeptics' Guide to EM

FEBRUARY 3, 2023

The nurses started CPR immediately and place pads before you even arrived. The patient is in ventricular fibrillation, and you achieve return of spontaneous circulation (ROSC) on the second shock. A post-arrest ECG doesn’t show any signs of STEMI. The patient is still unconscious.

Hyperthermia / Hypothermia 52

Hyperthermia / Hypothermia Hospitals Documentation/Coding Outcomes 52

RebelEM

MARCH 30, 2023

However, there are no clear guidelines for management in post-cardiac arrest patients without ST-segment elevations on ECG. Clinical Question : In patients who suffer an OHCA without ST-segment elevation on the post-resuscitation ECG, will early coronary angiogram (CAG) vs. delayed CAG improve outcomes?

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Hospitals Outcomes EKG/ECG Resuscitation 60

Ziqitza HealthCare Ltd

MAY 14, 2024

Not only immediate care but emergency ambulance services provide a safe haven to the patients by offering continuous pre-hospital care like administering medications, managing airways, controlling bleeding, CPR and other interventions. This can make the difference between life and death.

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Ambulance Services Hospitals CPR EKG/ECG 52

EMDocs

JANUARY 11, 2024

Data that do not establish neurological risk stratification in the first 6 hours after CA include the patient’s age, duration of CPR, seizure activity, serum lactate level or pH, Glasgow motor subscore in patients who received NMB or sedation, pupillary function in patients who received atropine, and optic nerve sheath diameter (95.3%, 20/21).

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Seizures Shock Infectious Diseases CPR 75

Critical Care Now

JUNE 21, 2022

CPR was started immediately after the coaching staff could not find a pulse and EMS arrived to find the patient in cardiac arrest. Paramedics continued chest compressions, gave epinephrine via an intraosseous route, and delivered one shock. His coach and fellow players witnessed a seizure-like activity immediately after collapsing.

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Seizures EKG/ECG CPR Shock 52

Taming the SRU

JUNE 6, 2023

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

Documentation/Coding 63

Documentation/Coding Seizures Psychiatric Wellness 63