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.

EKG/ECG 52

EKG/ECG Documentation/Coding CPR Shock 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).

Seizures 97

Seizures Shock Infectious Diseases CPR 97

Dr. Smith's ECG Blog

SEPTEMBER 3, 2023

This ECG was recorded in triage. The computer interpretation is: “Sinus Brady with moderate intraventricular conduction delay, nonspecific t wave abnormality, abnormal EKG” What do you think? Case Continued The ECG findings were not recognized. Therefore, no matter the initial ECG, record serial ECGs.

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EKG/ECG Resuscitation CPR Emergency Department 134

Taming the SRU

JUNE 26, 2024

Unresponsive patients with undetectable MAP or EtCO2 less than 20 should undergo CPR. Factors that improve survival rates include cardiac activity on ultrasound, initial shockable rhythm, witnessed arrest, extremity only trauma, and bystander CPR. One should ensure that the device is plugged in and an audible hum is heard.

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Blood Transfusions Sepsis CPR EKG/ECG 88

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 CPR Ultrasounds 52

Dr. Smith's ECG Blog

NOVEMBER 12, 2020

He had the following EKG recorded: Low voltage, suggests effusion. A bedside cardiac ultrasound was normal, with no effusion. He underwent CPR, and regained a pulse after epinephrine, with an organized narrow complex rhythm at 140, but still with severe shock. He was moderately hypoxic. He was intubated and then went pulseless.

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Shock EKG/ECG Outcomes Hospitals 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. These aren’t your standard arrest patients though, they typically have many fewer comorbidities – so CPR tends to be more successful. Let’s move on to treatment.

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Emergency Department Burns EKG/ECG Shock 40

Dr. Smith's ECG Blog

APRIL 8, 2016

Bedside ultrasound showed no effusion and moderately decreased LV function, with B-lines of pulmonary edema. Here is his ED ECG: There is obvious infero-posterior STEMI. This subsequent ECG was recorded after the K was up to 2.2 These two rhythms are often indistinguishable on the monitor or ECG. This was stented.

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Resuscitation EKG/ECG Hospitals Administration 52

Dr. Smith's ECG Blog

SEPTEMBER 16, 2015

Here is his ECG: The resident was alarmed at the "ST elevation in III with reciprocal ST depression in aVL" Are you alarmed? An elderly patient with a ruptured abdominal aortic aneurysm: Formal ECG Interpretation (final read in the chart!) : "Inferior ST elevation, lead III, with reciprocal ST depression in aVL." What do you think?

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EKG/ECG CPR Resuscitation Outcomes 40

EB Medicine

MARCH 1, 2019

Again, no standard definition exists, with some diagnostic criteria including simply chest pain and increasing cardiac enzymes, and others including cardiac dysfunction, ecg abnormalities, wall motion abnormalities, and an elevation of cardiac enzymes. New EKG findings requires admission for monitoring. of those patients.

Emergency Department 40

Emergency Department EKG/ECG Operations Fractures 40

Critical Care Now

JUNE 21, 2022

His main areas of interest are Critical Care, Ultrasound, Prehospital Resuscitation, and Medical Education. CPR was started immediately after the coaching staff could not find a pulse and EMS arrived to find the patient in cardiac arrest. His coach and fellow players witnessed a seizure-like activity immediately after collapsing.

Seizures 52

Seizures EKG/ECG CPR Shock 52